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 61

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 21 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 11 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 25 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
5.0 out of 5 stars 8 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

Leaking breast implants

Soreness and lumpiness are not normal after a breast augmentation.  You should definitely be checked on by your surgeon.  If your implants are saline, leaking of the implants usually results in a deflation and the breast abruptly decreases in size.  A silicone implant, placed recently is likely cohesive to some degree and does not "leak".  Firmness and soreness is often a sign of capsular contracture.  Please see your surgeon.

Shim Ching, MD
Honolulu Plastic Surgeon
4.5 out of 5 stars 26 reviews

Leaking Breast Implant Signs

Leaking Breast Implant Signs
For silicone implants prior to 2006, ruptures occur at rates of approximately 1-2% per year for the first ten years then markedly increases after that time period. A rupture or deflation of the implant may be experienced at any point after the initial augmentation; this complication may be increased by an under-filling or overfilling of saline solution into the implant, excessive compression, trauma, and other causes. (If the implant shell if not filled with the correct amount of saline, there may be a crease or fold in the shell which often leads to a rupture). You will be able to self-diagnose the need for an implant exchange (if using a saline implant) because if the current implant ruptures, the breast will shrink to approximately its preoperative size. A silicone implant that has a rupture is usually noted on a routine mammogram or MRI scan. In either case although the situation needs to be corrected on a timely basis, it is not dangerous to your health from our current knowledge base. Silicone implants after 2006 are more cohesive and less likely to leak. Most of the time, there are no symptoms such as soreness and misshapen lumps. 

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 90 reviews

Leaking implant?

Symptoms and signs of rupture depend on the implant type.  Saline implants have a built in indicator of leak; i.e., they just deflate and become much smaller, usually over a few days.  Silicone gel implants may show no signs of leakage; ruptures are often completely asymptomatic, or at worst may show some change in shape or hardening of the breast (capsule formation).  Capsules however, are usually NOT caused by implant rupture, even with silicone implants.  Furthermore, ruptures and typically not associated with new pain or masses in the breast.  You should see an experienced plastic surgeon for recommendations and assessment if you feel any new mass or lump, pain or hardness in your implanted breast.  imaging studies, such as an MRI or ultrasound may be necessary to sort out the cause.

Jeffrey D. Wagner, MD
Indianapolis Plastic Surgeon
4.5 out of 5 stars 6 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.