Leaking Silicone Implants in 4month Pregnancy?

The capsule around a failed silicone gel implant will contain all silicone. Removal may be done electively. An MRI scan is the best way to evaluate the integrity of the implant.

     While the ultrasound is not the most specific or sensitive test for rupture, diagnosing rupture at this point with an MRI may not be indicated given the pregnancy. 

I strongly recommend a magnetic reasonance scan to be carried out ASAP to assess what the problem is. In case of rupture, implants need to be removed urgently and replaced. This procedure can be performed under local anaesthesia, provided that you are fit and your gynaecologist agrees to the procedure.

In the short term there is nothing emergent about the leaking device.  If you were not pregnant and had a ruptured device it would be recommended to have it removed and replaced.

The implant capsule will contain the silicone from spreading in your body.  I would delay any treatment until after pregnancy.  After delivery, if the breast is symptomatic (capsular contracture), then I would do a capsulectomy with placement of a new implant.  Doing a diagnostic workup during pregnancy is unnecessary because surgery should be delayed regardless.

Sometines and Ultrasound can detect a rupture but the gold standard is MRI, best to ask your OB if this is possible. 

I'm sorry to hear about the concerns you have; I'm sure these concerns are “magnified” given that you are pregnant.

Keep in mind, that even in the event of a leaking silicone gel breast implant, most physicians would not recommend  breast implant related breast surgery while you are pregnant.  Therefore, in my opinion, there is no urgency to have MRI studies performed while you are pregnant. In other words, any imaging that you have performed now will not necessarily change the management of your breast implants (while you are pregnant).

On the other hand, an MRI study may be useful ( to evaluate the integrity of the breast implant shell) immediately after pregnancy.

 Of course, your own physicians will be in a much better position to provide you with precise advice.

 Best wishes for an  otherwise uneventful pregnancy and healthy infant.