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. 

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!

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!

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. 

The only definitive way to determine if a silicone breast implant is ruptured is by way of a MRI. Mammograms and ultrasounds are not as sensitive as MRIs. The incidence however of a silicone implant rupturing in the first decade is quite low, around 8%. Consult with your plastic surgeon in person for more specific details regarding silicone implant rupture.Best wishes,Dr.Bruno

Breast implants these days are very well made.  One of the differences between saline and silicone is when saline ruptures or has a leak, you breast will eventually deflate and now you are in someone urgent need to get it replaced because you will obviously be uneven.Silicone implants don't leak but may have a breast in the shell.  Due to the cohesive (gummy bear) nature of the implants, the breast will not change shape, and there is no good way to detect this during a physical exam.  There are some signs that can be detected by a good exam, but ideally an MRI is needed to determine if the implants are intact or not.  The FDA has deemed silicone implants as safe and there really should be no worry about all the things that have been talked about in the past.  The FDA recommends patients with silicone breast implants to undergo an MRI at 3 years time from their surgery and then every 2 years after.Hope that helps.

It's a very good question and it is an important difference between saline and silicone. If a saline implant ruptures you know it after just a few days as the implant deflates. However there are downsides to saline implants. They tend to show more visible rippling and feel less natural and silicone. Silicone implants feel more natural, have less chance of rippling, and the latest generation cohesive gel implants do a good job of keeping fullness at the top of the breasts where most women want it. It's important to know that the latest generation of silicone implants are actually a silicone solid. They are not a silicone liquid, so when they rupture the inner silicone does not leak out into the body. This is an important safety feature. It is indeed more difficult to diagnose ruptures with silicone and it requires an MRI or high-resolution ultrasound. Taking all of these factors into account, most women are still choosing silicone implants. 

Thank you for your question.  The best way to diagnose a silicone gel implant shell tear or 'rupture' is with a MRI.  I recommend that patients go for their first MRI about 3 years after their breast augmentation procedure to ensure that there are no silent ruptures.  A silicone gel implant shell tear or rupture is usually asymptomatic and therefore the best screening tool is yearly follow up with your operating surgeon and MRI's at your operating surgeons discretion.  I hope you find this helpful!  

For peace of mind and a newly FDA approved and available implant consider the IDEAL Implant - a double lumen saline implant made to feel like silicone. My patients love them ! 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 or have silicone migration. Only an x-ray or ultrasound study will determine if you have a rupture.