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.
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.
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.
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.
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.
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.
What happens when my implants leak?
Great question - there are two scenarios to consider - silicone gel implants and also saline implants. When saline implants leak you will go to bed with two equal breasts and wake up with one much smaller than the other... But - if you have silicone gel implants it will not be clear from either appearance or a physical exam when and if the implant leaks... the only way to know that an implant (gel) is leaking is by getting a breast MRI- and do not worry a leaking gel implant is both rare and not harmful to your health.
That being said your concerns and symptoms are somewhat unusual and definitely worth getting checked out. Best of luck.
It's possible that there is a capsule forming, which is scar tissue around the breast implant. It's also possible that the implants are ruptured. Best to go in for an exam and ultrasound to evaluate the implants. Pain can be a sign of capsular contracture as well...
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!
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.