Signs of Leaking Breast Implants

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.

Firmness of implants can be caused by capsular contracture, a tightening process that we don't really understand but is treatable (basically by cutting the capsule and softening the breast). Implants that have leaked may feel firm because they have folded down on themselves, like a deflated beachball. You really need to see your surgeon. In my office, we also do ultrasound scans of the implants. You are clearly not comfortable and need to be evaluated. I have attached a link to my website in case you wish to read more.

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.

When saline implants leak, it's generally obvious because the saline (salt water) is absorbed by the body and disappears from the breast. That breast would look and feel much smaller than the other breast. If silicone implants leak, the silicone usually remains around the implant, still in the breast. That means that the breast may not look or feel much different even if silicone is leaking. Sometimes it's possible for a plastic surgeon to determine this by examination. If there's doubt, the best test to determine whether silicone implants are leaking is an MRI. This study is very accurate, but can be costly and may not be covered by health insurance. If you're not satisfied with the look for feel of your breasts, or if the hardness is causing discomfort, you may wish to consider a revision breast surgery whether the implants have leaked or not. You may have developed capsular contracture (tight, firm scar tissue around the implants) or other conditions which can potentially be improved. 

If you lie flat and you have implants, if you feel that the implant migrates to the sides of the breasts, you might have something known as implant malposition. This typically occurs when the pocket stretches, or maybe the muscle forces the implant down and out, stretches the pocket, lateralizing the implant position. This means you may need revisionary surgery, tighten the pocket, move the breast implant more medially and secure the breast implant. If you have breast lump, please see your doctor to get that evaluated by an ultrasound or mammogram to rule out anything bad.

Diagnosing breast implant rupture without imaging studies is very difficult. I recommend visiting your plastic surgeon, who would probably ask for an ultrasound or MRI to check integrity of both implants.

It's a great question. The answer really depends on what type of implants you have. If saline implants leak, they simply deflate, your body absorbs the saline fluid, and there are no issues. It's important to know that the latest generation of silicone implants are made of a solid silicone gel, so they don't leak out if the shell were to break. This is an important safety feature. Older liquid silicone can cause irritation of the tissues when it leaks out around the implant. If you suspect a rupture, it's important to contact a board-certified plastic surgeon so that you can be seen in person. They will examine you and may order imaging (typically an MRI).

The perceived presence of a lump after a #breastaugmentation is a potentially serious matter that should not be ignored. With silicone implants you will need an MRI to determine if your implants have been compromised.  For saline implants, you can typically tell by a physical assessment as the breasts will be asymmetrical in size/shape.   Schedule a follow up appointment with your surgeon for evaluation of your breasts to determine if you are indeed experiencing an implant rupture or another health concern.

Thank you for your question!  Depending on the type of implant you have will help to diagnose if the implant is actually ruptured.  For example, with saline filled implants, you may notice your fullness may decrease over time or you may lose fullness overnight.  It depends on the size of the rupture with saline implants that would dictate how quickly your rupture may take to notice.  It is a different story with silicone filled implants, especially the newer generation of implants. Most often, with silicone filled implants, the rupture may be picked up on incidental findings with a CT scan for some other concern.   Mammograms may pick up a rupture as well, but are not as accurate as a MRI scan.  So if your physician is concerned about a potential rupture, a MRI would typically be ordered.  Symptoms may be vague as well and a detailed history may help to explain which diagnostic test may need to be ordered. Pain, a change in breast shape, recent trauma,  are other examples of potential need for further workup.  I would suggest you speak with your surgeon for any concerns you have with your implants.  

Thank you for your question.  It is difficult to say without examining you what exactly is happening.  The hardness and discomfort you are feeling may be due to capsular contracture, which can be a difficult problem and is often managed surgically if symptomatic.  Leaking saline implants will ultimately end in the deflation of the implant, which will be quite obvious; leaking or ruptured silicone implants are far more difficult to detect clinically, and usually require an MRI to diagnose.  I would recommend seeing your surgeon for and in-person examination to determine the appropriate course of action.