How Do You Know when There is a Rupture with Silicone Implants?

The most reliable test (100% accurate) to check if a silicone breast implant is leaking is surgery, but this is not practical unless we are planning to operate anyway. Physical examination is only about 30% effective in detecting silicone breast implant leaks. So while it is simple, painless and cheap, it is not particularly effective.

Magnetic Resonance Imaging (MRI) is the most reliable "non-invasive" test to see if silicone breast implants are leaking. MRI is reportedly 90% accurate, painless and expensive. The research was done in women who had symptoms. There is evidence that MRI will not be as accurate in women with no symptoms. Regardless, the FDA has recommended women with silicone breast implants have an MRI at three years after breast augmentation surgery, and then every two years after that to check for silent leaks.

Mammography and ultrasound are not reliable means of evaluating silicone breast implant integrity, as they give too many false positives (detecting a leak when there isn't one) and false negatives (missing leaks). 

It should be said, an advantage of saline breast implants is that if there is a leak, the implant deflates, and no special test is needed to tell. For saline implants, physical examination is 100% accurate. No MRI is necessary.

More information is available is available at the link below, including warrantee information from Allergan and Mentor.

When a silicone implant leaks, the silicone generally stays around the implant. That means that the breast may not change in size, shape, or the way it feels. There is a lot of evidence suggesting that silicone on the outside of the implant didn’t usually cause problems, but the only way to know for sure is to obtain an MRI of the breasts, or to do surgery and replace them. 

It can be difficult to tell just by self-examination whether there is a leak in a silicone implant.So, the best method to tell is to get regular imaging of the breast, with an MRI or high-resolution ultrasound.  MRI is slightly more accurate, but more expensive.  That is an extra bit of "homework" that you should do, if you choose a silicone implant.

Thank you for your question! I recommend getting an MRI of the breasts to detect implant rupture. With silicone gel implants, you aren't able to physically see the appearance of a ruptured implant, whereas with saline implants, you will see a deflated breast with implant rupture. I hope this helps!

Thank you for the question. It is not always easy to detect a silicone rupture on physical exam, so we usually rely on some type of imaging study. The gold standard test to detect a rupture is an MRI. However, I have also seen screening mammogram as well as ultrasound detect silicone ruptures. The current studies show a rupture rate of only seven percent at ten years with the newest, highly cohesive gel implants, so they should last a long time. however, no implant is a lifetime device. Good luck!

Typically with a saline implant rupture the breast will get smaller when there is a rupture. This is because the saline (salt water) leaks out and is absorbed harmlessly by the body. However, when a silicone gel implant ruptures, or more commonly develops a tear in the shell, the gel often mostly stays within the implant shell. The gel that does leak out is contained within the implant capsule. The capsule is the scar layer that surrounds the implant.  Often times detection of a silicone gel rupture requires a diagnostic test such as an MRI or an ultrasound. If you are concerned about having an undetected gel rupture, but prefer the feel and shape of gel implants you should consider Ideal Implants. These are structured saline implants that have internal baffles to mimic the structure of cohesive gel implants. However, like a standard saline implant, when they leak, the deflate and the breast gets smaller.