Signs of Leaking Breast Implants

I've had my breast implants for about 4 years.  When I lie down my implants sometimes feel like a misshapen, hard lump.  I can also feel the implants and some soreness. Are these signs my breast implants are leaking?  How can I tell?

Doctor Answers 68

Soreness and lumps should always be addressed

By now, I hope your problem is resolved and that you went to see your doctor when you identified that you had a problem. In general, silicone gel filled implants need an MRI X-ray to determine if they are leaking. With saline implants, you'll know because your breasts will return to their original size and you won't fill out your clothes symmetrically. 

Philadelphia Plastic Surgeon
5.0 out of 5 stars 28 reviews

Depends on the implant

These do not sound like signs of leaking from a saline implant.  However, they could be associated with leaking from a silicone implant.  You need to visit with a board certified plastic surgeon, and possibly get an MRI if you have silicone implants.  Either way, it is always best to have someone examine you if you are having problems.

Signs of leaking breast implants

Thank you for your question. If you have saline implant, it is very easy to tell since a rupture causes the saline to leak out and the body simply reabsorbs the "salt water". In addition the appearance of the breast rapidly decreases in size since the water is absorbed very quickly.
Silicone implants are a little more difficult to tell if they have ruptured. A ruptured silicone implant may not cause a misshapen appearance to the breast or hard lumps since the gel is cohesive and should not "leak" out. However, I have seen ruptured implants cause a "capsular contracture" which can cause the hardness you are speaking about. The best way to diagnose a ruptured implant is with an MRI. The FDA recommends an MRI every 2-3 years after a breast augmentation. However, most women do not opt to have MRIs since they are an "out-of-pocket" expense. Since you ARE having symptoms, I would recommend visiting your plastic surgeon to make a decision about ordering an MRI.

Signs of Leak

If you have saline breast implants, it's easy to tell if they are leaking.  They deflate quickly and the body harmlessly absorbs the saline so that breast looks deflated and significantly smaller then the side that is not deflated.  This usually happens over a period of a few days.

If you have silicone based implants then it is a litter harder to tell.  The new implants don't leak everywhere so they usually present as some change in the look of feel of the implant.  A breast that was completely normal for several years may begin to change in appearance or become harder or more tender.  However, because the volume remains the same, there usually isn't any obvious deflation.  The only sure way to tell is to get an ultrasound or MRI.   

If you suspect a leak then you should see a board certified plastic surgeon to determine if you need to get further testing.  If there is leak or rupture then that implant needs to be removed and exchanged for another one.

Adam Hamawy, MD
Princeton Plastic Surgeon
5.0 out of 5 stars 31 reviews

Hard lump in the breast

Changes in the feel and shape of the implants can indicate a rupture or the development of a capsular contracture.  Saline implants will deflate if ruptured but it is often difficult to tell if a silicone implant is ruptured.  

Changes in the breast and new lumps of tenderness should be evaluated by a physician.

Michelle J. Place, MD
Danville Plastic Surgeon
4.5 out of 5 stars 9 reviews

Firmness in breast

 When saline implants leak, they will deflate and become smaller. The new gels may not show any signs of leakage.  If you have a hard lump, please see your family physician or plastic surgeon.  You may have some scar tissue or capsule formation occurring, or there may be another problem.  Please do not ignore the lump.

Connie Hiers, MD
San Antonio Plastic Surgeon
4.5 out of 5 stars 12 reviews

Signs of Leaking Breast Implants

If your implants are saline then they will decrease in size fairly quickly if they are ruptured.  Gel implants can be more difficult to evaluate for rupture.  What you describe is not a typical story for rupture but closer to capsular contracture.  They best evaluation for rupture for gel implants is an MRI.  Visit your plastic surgeon to discuss the problem and be evaluated.

Susan D. Vasko, MD, FACS
Columbus Plastic Surgeon
4.5 out of 5 stars 6 reviews

Breast implant leaking

Implants can leak; this is harder to detect if the implants are silicone as the gel material may be more cohesive and the implant may not deflate as much.  The symptoms you describe of pain, discomfort, and hardness may be relate to leak but it also may be related to capsular contracture, which is scarring around the implant over time.  There is an increased risk each year you have implants, while the overall risk is still very low.
The only way to tell the cause of your symptoms would be to see a plastic surgeon who can decide whether you need an imaging study or possible replacement of the implants.  Good luck!

Kailash Narasimhan, MD
Sherman Plastic Surgeon
5.0 out of 5 stars 9 reviews

Breast Implant Questions

Any questions regarding a lump in the breast after breast augmentation are best evaluated by your Plastic Surgeon or one of your other doctors.  Additional evaluation can be done with X-ray and or MRI if necessary as well.  It would not be very common to experience a leak of an implant after only 4 years, but this should be evaluated by your doctor in order to provide you with important information and hopefully peace of mind.  

An examination with your surgeon is needed

With regards to hard lumps felt on the breasts after breast augmentation, the only way to truly work this up is with an examination by your surgeon and very often a subsequent imaging study of some type which could include an ultrasound or mammogram. Depending on whether you have saline or silicone and depending on whether you have a rupture these factors can affect how the implants feel under the breast tissue.

Generally, with silicone implants a leak will not be noticed as it is usually considered a “silent rupture”. With saline implants usually when it leaks the implant will deflate and there will not be any more significant volume and this is a very noticeable issue. My best advice would be to see your original surgeon, have them examine your breasts and perform followup studies as needed to rule out anything more serious then palpability of the implant.

Robert Cohen, MD
Santa Monica Plastic Surgeon
5.0 out of 5 stars 34 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.