Saline breast implants can have different types of leaks. If there is an implant rupture (or hole in the shell of the implant), the leak is usually quick and obvious, and the breast appears deflated as the body resorbs the fluid. Less commonly, the implant can leak due to a valve malfunction. If so, the leak may be a slow leak as it can leak on and off depending on the amount of pressure and whether or not the valve is seated in place. (Saline implants are filled through a valve that is securely closed upon removing the tube used to fill the implant. In some cases the valve can become incompetent over time and lead to a slow leak.) Typically the easiest way to tell if there is a leak is by physical exam. Imaging studies are not usually needed for saline implant leaks, but are an option if it is unclear. Regardless of whether there is a leak or not, if you feel you have developed asymmetry compared to before, you may need another operation to restore symmetry. Changes over time can be due to many things, some implant related, and some simply age related.
Physical examination of your breasts as well as a history of sudden change in size or shape of the breasts will confirm that the breast implant is leaking. Generally, the breasts will feel softer and you may feel more irregularity and/or rippling of the implant itself (than before the deflation).
It may be that during your examination your surgeon was unsure of the answer to question–sometimes if there is a leakage of an implant it will undergo the changes described above over time.
How Can I Tell if my Saline Implants Are Leaking? Answer:
While rare, they do occur and in my experience it comes from an incompetent valve that loses volume when the implant is full and pressure in the implant is high, and then stops leaking when enough saline is gone to lower the pressure in the implant and it starts holding again. And I have seen capsules stretch where the implant feels really loose, like its losing saline, but not. In both of these cases, unfortunately, you usually have to operate to tell! Pinholes usually go flat fast!
If your implant has deflated it is usually very apparent. A simple physical exam in most cases is all that is needed.
Is my saline breast implant leaking?
Saline implants can leak. It is uncommon but a known complication. The leak rates can be around 6% at 10 years. Usually, when a leak occurs, the implant deflates within a few days. In this situation, the body absorbs teh salt water and it becomes very obvious that your implant has deflated....like a flat tire. It is possible to have a slow leak but this is much more uncommon. If there is a small pin hole, the fluid will leak very slowly and it may take weeks to become obvious. There is no good test to determine if you have a very small and slow leak. The best thing to do is to just wait and try to not to agonize over it. Slight changes in volume and shape can occur as you progress through the healing process and does not necessary mean that there is a leak.
Saline implant leaking? How to know for sure.
Smaller and softer are sure signs that a saline implant is leaking. Your subjective sensation may be something else entirely, but even a tiny pinhole leak will eventually deflate, especially if you squeeze and feel your breasts to "check" them. BTW, textured saline implants leak much more commonly than smooth ones.
No other tests or consultations are necessary. Pick a time for replacement surgery. Discuss the costs with your surgeon--you will likely be pleasantly surprised.
This might be a good time to suggest silicone gel implants--the present 5th generation is made of a cohesive silicone gel that CANNOT leak or rupture, and IMHO, does NOT require periodic MRI scans to look for leak or rupture. (They can't leak or rupture, so what are you looking for? Not to mention that the MRI is WRONG 21% of the time--FDA data). The slightly higher cost of silicone implants will be reduced by the cost of the saline, so now is the time. You will love the softer, more natural feel! For more information on silicone implants, click on the link below. Best wishes!
If you are noticing a gradual decrease in the size of one breast, it is very possible that your implant is leaking. While most commonly a leaking saline implant will 'deflate' rapidly (i.e. over the course of one day), you may be experiencing a very uncommon 'slow leak' which is still treated with an implant replacement. It is highly unlikely that you are feeling the implant leak and more likely you are noting the size change. As the size discrepancy between the two breast becomes more noticeable, return to your plastic surgeon to develop an immediate treatment plan. Best of luck!
In general the implant usually leaks down rapidly over a few days if that is the problem. Then there is no doubt. Donald R. Nunn MD Atlanta Plastic Surgeon.
Unlikely to actually feel leaking
While is it unlikely that what you are feeling is actually the leaking of your saline implant, if you notice that one side is getting smaller than the other side, then you likely are having a deflation of one side. I suggest you go back to your plastic surgeon and get it replaced. Usually, in my experience, whenever a saline implant deflates, it does so rather rapidly, often overnight. Slow leaks are uncommon, but can happen too.
Lost volume is the key to saline leak
A slow leak in a saline breast implant is not common and in our experience if a leak develops the volume loss is rapid and dramatic. A slow leak is possible and again volume loss is the key, quite simply is the implant has become smaller it is leaking. You probably won't feel the leak, though it will be plain over time. See your surgeon again, compare your photos, and see if an early replacement might be an easier undertaking.
Best of luck,