Pregnant and Implants May Have Ruptured

The first thing to know is that even if your implants are leaking, saline is just salt water and not toxic in any way to you or to your baby. So you do not have to worry about that. In the worst case scenario, the implants have deflated, and you have lost the results of your augmentation, but this is not an emergency. You can choose to have them removed or replaced after the baby is born and 6 months after you have finished nursing. However, it is unlikely that both implants would have leaked at the same time. On the other hand, breasts can change alot during pregnancy getting larger and softer and maybe more floppy, so perhaps this is the cause of the changes you are seeing.  At any rate, be comfortable that there is no risk to you or your baby, elective surgery should be avoided during pregnancy. After the baby is delivered is time to sort it all out.

In this case your primary concern is your pregnancy and having a healthy baby and not the ruptured saline implant. There is no urgency in this situation to do anything. The saline will be harmlessly absorbed by your body. Following your delivery you can have your surgeon or a local board certified plastic surgeon replace the implant at that time.

Pregnancy represents a physiologic state in which your immunity is diminished to accomodate the growing fetus. It is possible that you have developed increased severity of your capsular contracture during your pregnancy.  This is more plausible than a partial saline implant leak. In breast implant ruptures or implant leaks with saline, the breast will flatten out immediately.  

Since you are in your third trimester, this makes it very hard to know what is going on with the implants since you undoubtedly have alot more breast tissue now then before your pregnancy.  This may actually just be a consequence of the breasts getting larger and there being more room now for the implants to move a little.  The only way to know is to find a board certified plastic surgeon in your area.  You could also call your previous surgeon and see if they have any recommendations for your area.

If these are saline, essentially the leaking saline will be absorbed by your body. The primary concern will be contraction of the breast. Replacement tends to be a simpler procedure with less pain than the initial procedure. IF you are intent on using the umbilical approach then I would contact your original surgeon. Depending on their technique, these could potentially be replaced under local. The physician may have concerns about operating on a lactating breast and this should be discussed with them.