Silicone Breast Implant Getting Smaller?

Question

I've had my implants for a few years now. They are the silcone gel and in the last month one has decreased in size. What could cause this to happen?

Otto Joseph Placik, MD · Answer

Silicone Breast Implant Getting Smaller? This is interesting because technically speaking silicones don't get smaller unless ruptured or part of a double lumen implant. You may require MRI testiing t evaluate the implant.

George Marosan, MD · Answer

If you had your augmentation a few years ago and now you notice change in size, it is most likely a capsular contracture. The breast which is smaller now, might also feel firmer than the other side. With gel implants you will not loose volume as it happens with saline implants when they leak. You need to go back to your surgeon to be reevaluated for the change in size.

Richard Baxter, MD · Answer

Unlike saline implants which are filled with liquid saline solution the gel in silicone implants is semisolid, so even if the shell of the implant was sliced open the gel wouldn't spill out. That leaves only a few other explanations for the implant appearing smaller. One is capsular contracture, which is a compression of the scar capsule around the implant. That could make the breast appear smaller but it would also feel hard. The other is that your breast tissue is changing, along with perhaps some settling of the implant. That is actually more likely. Either way, it is a good idea to have your plastic surgeon check it out.

Steven Wallach, MD · Answer

Unless you have lost weight, I would suspect a rupture of the implant and suggest you get an MRI to determine this.

Peter A. Aldea, MD · Answer

All implants eventually fail when the shell weakens and they leak. While there is a gradual deflation with Saline breast implant, often there is NO volume change with silicone gel filled implants. The diagnosis is usually made with MRI imaging based on patients complaints of non-specific symptoms.

	When women develop CAPSULAR CONTRACTURE, the scar which normally forms around ALL implants (and other foreign bodies) becomes thicker and begins to exert 360 degree pressure on the implant squeezing it in. This is often manifested as a smaller, rounder appearing breast on the affected side. You should see your Plastic surgeon to have it checked out.

Leonard Harris, MD · Answer

Sometimes a capsular contracture will make the breast seem smaller . If the smaller side is also very firm that may be the problem. You should have a proper examination by your surgeon to discuss treatment options.

Darryl J. Blinski, MD · Answer

Very concerning issue. seek an evaluation by a boarded plastic surgeon quickly. You need either a mammogram or MRI to determine if there is a ruptured implant.

	From MIAMI DR. B

Steven Schuster, MD, FACS · Answer

If you had your gel implants placed in the USA by a reputable plastic surgeon then you should not fear that there is liquid silicone running through your body.  The new (past ~14 years) are a gel and actually does not leak.  If the implant is smaller it may be due to a capsular contracture or hardening around the breast implant.  This compresses the implant so it can't move normally and may distort the shape, make it feel very firm or even cause pain.  The other possibility is that there is compression of the breast tissue giving you an apparent decrease in size.

	If this is a fairly new and rapid occurence I would make an appointment to see your plastic surgeon even if only to be reassured.  Good luck.

Daniel P. Markmann, MD · Answer

If you are noticing a change in the size of your breast, it is most likely not a loss of volume of your silicone implant. It may be a change in shape due to settling of the implant, developing a capsular contracture, or if you already had a capsular contracture and tore the capsule, this would soften and flatten your implant. But, the most common reason for change in breast sizi is due to a change in a woman's weight. There is also the possibility that you may have had cysts in your breast that may have shrunken. But, the implant, if it is silicone, cannot change size.

Kenneth R. Francis, MD, FACS · Answer

Although more classic for saline leakage, a decrease in your silicone gel augmented breast size might indicate a leak. When the gel leaks from an implant it usually remains enclosed within the scar tissue capsule that has formed around your implant. If this capsule is larger than the implant capsule, the gel will spread over a larger surface area and the breast will flatten or decrease in size somewhat. You should consult with a plastic surgeon in your area. You may need an MRI study. Good luck!

Silicone Breast Implant Getting Smaller?

Answers (13)

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