What Worse Can Happen if Breast Implants Are Not Removed After They Rupture, Leak into the Body and Are Still Not Taken Out?

With saline implants, if the implant breaks, the saline is absorbed by the body (it is the same saline that is used in your IV during surgery so it won't hurt you).  Instead of having a full implant, you will simply have a deflated implant until the time that you have it removed/replaced.

The newer silicone gel implants are called cohesive gel.  They are very soft but are so sticky and cohesive that you can literally cut into them and they will hold their shape.  In fact, I keep one in my office that I cut to show to my patients.  This feature makes a ruptured implant easier to remove intact but more difficult to detect using conventional techniques.  An MRI may be necessary to fully determine whether or not a cohesive gel implant is actually ruptured.  Even with a ruptured implant, you might go for a very long period of time without any problems.  The main problem that you might encounter would be a capsular contracture, the formation of thickened scar tissue around the broken implant which can make the breast feel firm or distort the shape of the breast.  When this happens, surgery may be required to remove the scar tissue and replace the broken implant.

     If saline implants rupture they deflate and most patients want to have them replaced.  If silicone implants rupture, the breasts may change shape or they may not change in shape.  Some patients who have rupture with silicone are unaware of the rupture, and these are found to be ruptured during surgery.  According to the lastest studies, there is probably very little effect on silicone in the breast capsule.

Ruptured gel implants should be removed as over time the gel can migrate from the implant and capsule and form a siliconoma which is a lump of free silicone surrounded by scar tissue.  This does not cause a disease process but may be visible and felt.  Saline as stated above.

Deflated saline implants just appear flat.  Silicone implants may take on a different shape but will not migrate all over the body.  But it is best to have them removed.

If saline implants rupture the implants will deflate, and the saline will be resorbed.  In most cases the remaining implant will not cause a medical problem.  If Silicone gel implants rupture, in most cases the gel will remain within the breast capsule that the body has formed and may not pose a problem.  However, if the silicone gel escapes into the surrounding breast or lymphatic tissues the silicone can on some occasions cause problems such as infections or lymphedema.  Therefore, if a silicone gel implant is noted to be ruptured it should be removed and/or replaced.  A new form stable silicone implant (Gummy Bear Implant) (Silimed Implants - Sientra) is now available on the market.  These form stable silicone implants do not leak even if punctured or cut, and should reduce the above risks associated with silicone implant rupture.

You did not say if you had saline or silicone gel implants.  If you have saline implants, you will end up with an empty bag that will need to be removed.  No harm to the body at all if they leak.  If you have gel, the gel will stay inside the scar around the implant until your surgeon removes it.  With the years of studies on gel implants, the conclusion was they are very safe.