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What If Your Breast Implant Ruptures?

So, what do you do if your breast implant ruptures and how do you even know for sure that it has?

First of all, Dear Readers, I remind you that this blog is not intended to be a source for medical advice. If you have questions or concerns, always speak with your doctor.

Let’s talk about it.

Note: Much of this info also applies to women who have chosen implants for cosmetic reasons, nothing to do with breast cancer. For obvious reasons, my focus is for women who’ve undergone breast reconstruction following a cancer diagnosis and mastectomy or those choosing prophylactic mastectomy and reconstruction using implants.

If you chose, or plan to choose reconstruction following your mastectomy and you decided on breast implants, or if you’re thinking about them, it’s important to understand what your followup plan should be.

Implants are not a one-time and then you’re done type of deal. They are medical devices and not intended to last a lifetime. Be sure to discuss this with your care team too. Again, there will be followup. Ask about it.

The FDA recommendation is that you have a breast-imaging MRI at three years following initial placement and then every two years after that.

Here’s another example of “do what I say not what I did”.

Although to be fair, some doctors do not believe all the surveillance is necessary. Regardless, talk to YOUR doctor about YOUR followup plan and be sure you’re both on the same page.

Forever the procrastinator, I am definitely not the poster woman for doing this right as I didn’t have an MRI to check on my implants until just recently, and it’s been over eight years since mine were placed. Oops…

Of course, if you develop symptoms of a rupture such as breast pain, redness, hardness, swelling, change in breast size or anything else that concerns you, don’t wait.

Talk to your plastic surgeon right away to discuss.

When an MRI is recommended, be prepared for an unpleasant experience. Mine was anyway. I could write an entire blog post about that, but that’s for another day.

Let’s just say, when the ordeal was over, I sat up, and immediately said to my technician, “I’m going to cry now”.

“I understand, go right ahead,” was her response.

And I did. (Not due to pain, so don’t worry, it doesn’t hurt.)

Apparently, MRIs with implants take longer, in some cases, a lot longer.

There are two kinds of ruptures, intra-capsular and extra-capsular.

An intra-capsular rupture means silicone gel has escaped through a hole or tear but is contained within the scar tissue capsule that has formed around the implant. (This scar tissue formation is normal.) This sort of rupture generally starts off anyway with no symptoms. This is called a silent rupture.

Silent ruptures are a primary reason for those aforementioned FDA guidelines.

An extra-capsular rupture means silicone (amount varies depending on size of rupture) has made its way past the capsule. If and when the gel moves to other parts of the body, this is called gel migration. Symptoms are more likely with an extra-capsular rupture.

If you have saline implants, a rupture generally means deflation has occurred. This is easier to detect visually as the breast will appear smaller over a relatively short time span, usually in just days.

It’s important to note that there is debate about the safety of silicone gel once it’s leaked out and even if it hasn’t. (This particular post isn’t about that.)

In addition, you’ve likely heard about textured silicone implants being banned in Europe and Canada. Breast implant complications are still being studied and the controversy likely isn’t going away anytime soon.

If you’re concerned about breast implant safety, be your own best advocate. Do your research and ask questions of your doctor until you’re reasonably satisfied with the answers.

I’m planning a post on Breast Implant Illness, so stay tuned for that.

So now, let’s say you’ve had your breast imaging MRI and things look good. Yay! You’re good to go for another couple years.

What happens if your MRI shows a rupture?

This is where the story circles back to yours truly. Yes, my MRI spotted a rupture. We have no idea how long it’s been there. (Because, you know, that procrastinating thing…)

This is why it’s called a silent rupture. No symptoms. Who knew?

It’s also just one more reason why this breast cancer shitstorm is NEVER OVER.

Hence, you might need to allow yourself to feel upset that you must deal with this particular mess again. Feelings of fear, anger and yes, grief for your original female parts might resurface. They have for me anyway.

So, I’ve been trying to cut myself and Dear Hubby, too, some slack.

You might want to read, Nipple Envy and/or Things We Aren’t Supposed to Say about Mastectomies, Reconstruction & Breasts.

If a silent rupture is detected (or a not silent one), the general recommendation is for the implant to be removed. A silent rupture is not considered an emergency.

(Not that this makes us feel much better about it.)

Some doctors say it’s okay to take the wait and see approach for awhile. Some might disagree with that approach.

Regardless, it’s important to carefully consider and think through all your options.

So, what are they? (Keeping it real, they all kinda suck.)

  1. Remove the implant(s) and be done. Going flat is a reasonable and good option for many. It might even be the best one for you.
  2. Replace the implant(s) with similar-size implants or smaller ones (I found out the latter is involved, but I’ll spare you the details here) and then carry on.
  3. Consider an autologous procedure if you’re a candidate. This means a reconstruction procedure using your own body’s tissue. (I’m currently researching the DIEP flap procedure.)

I am now in information-gathering mode about ALL my options. (Plastic surgeon #4, here I come.) This go-around, I plan to take my time. You might think what to do would be a relatively “easy” decision.

But for me, it’s not.

FYI, #2 – the swap-out deal, is not quite as quick and easy as you might think, even if you choose same-size implants. Or not as quick and easy as I thought anyway. It’s still surgery. There are still drains. There is still healing required. There is still recovery time needed. Ugh…

What to do at this juncture, too, is all about personal choice and shared decision making with your doctor.

If you experience an implant rupture, what you decide to do is up to you and you alone.

At some point, I’ll let you know what I decide.

Update: The option I chose was DIEP flap surgery. You might want to read, DIEP flap breast reconstruction surgery during a pandemic, is it safe? (Updates & reflections about my experience)

What’s it like six months post DIEP flap surgery?

To get more articles like this one delivered weekly to your inbox, Click Here! #KeepingItReal #SupportYouCanUse

If applicable, did you choose breast reconstruction or did you opt out?

No matter what your decision was, why did you choose it?

Do you have breast implants and if so, do you understand your followup plan?

Have you had an implant rupture?

Featured image above via Wikimedia Commons

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What if your breast implant ruptures and how do you know for sure it has? #breastimplant #breastcancer #mastectomy #reconstruction #plasticsurgery #womenshealth

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Pat Jones

Monday 14th of June 2021

Not a rupture, but I had capsular contracture on one side. The surgery to remove and replace the implant was so easy (on me….he said it wasn’t an easy surgery) and no drain. Both sides looked identical immediately.

Monica

Wednesday 9th of June 2021

Nancy, I sorry you have to go through that. I hope it goes well for you. My removal and replacement surgeries went well and were so much less painful, so dont panic about the pain.

I had a double mastectomy 9 years ago. I chose reconstruction with Saline, sibce I also have a pacemaker. Because of that, I cannot get MRIs, so i would not be able to have followups. With the saline, i dont need the Mris. However, my recovery from my surgeries did not go as smoothly. I had an infection and had my left implant removed. My right had a half filled TE. I had the left replaced 6 months later. It went well, until another infection. Repeat. But this time I waited another full year before replacing it, when it finally stuck. And then both TEs were filled and finally 3 years after my first implant, I had my squishies. In the meantime, I had a small prosthetic for my half filled right side. I had a full size prosthetic for my left. I got through it. And have no issues at this time. Keeping my fingers crossed because next year, my pacemaker will need to be updated and I hope it doesnt disturb anything. One other thing, im pretty sure I was told that the implants last only 15 years or so? Not sure about that, but thats also something to consider, although Im grateful Im still here to think about those thungs. Hugs to all going through this mess.

Nancy

Monday 14th of June 2021

Monica, Yeah, the rupture thing and the MRI wasn't pleasant. Nor was the idea of facing another major surgery. But we do what we need to do, right? I'm sorry you had so many complications with your reconstruction, but I'm glad things are okay now. It's generally said that the life of implants is in the ten year range and yes, that's definitely something to consider. Can't say that I even thought about that when mine were originally placed. I know better now. Thank you for reading and sharing.

Debby

Wednesday 26th of May 2021

I've had reconstruction . The implant that the is silicone and large, but because of the other older sagging breast, face on doesn't look too bad. Unfortunately the problem is pain, pulling and creepy crawlers up and down my side and back. Did PT, maofacial, massage, Lyrica, and baclofen( muscle relaxer ) . He feels that swapping it out for a smaller implant would not help. Implant does not seem to have constricure and moves around well. Thoughts? In pain, Help!

Nancy

Tuesday 1st of June 2021

Debby, I'm sorry to hear about your pain. You didn't mention how long it'd been since your implant was placed. Healing can take a while. If you've had it awhile, perhaps an MRI is called for, but I'm not in a position to advise appropriately. You deserve help in getting things figured out. My best to you and thank you for sharing. Hope you get some answers/relief.

Jessica

Friday 14th of February 2020

Any updates about your rupture? Just confirmed today (with an MRI earlier this week) that I have a intra/extracapsular rupture in one of my two implants only a year out from my bilateral mastectomy and direct-to-implant reconstruction. I'm not sure what I'm going to do - I'm scared to choose to put implants back in and have to deal with this again in the future, but I'm not sure I'm ready to go flat (I already have had some body image issues after surgery and treatment - I'm turning 40 this month) and I was happy with my appearance following reconstruction. I can't help also feeling some guilt about what feels like a vain problem and minor inconvenience (surgery) compared to my friends who are managing later stage diagnoses and have frequent procedures and treatments.

Nancy

Tuesday 18th of February 2020

Jessica, I have made my decision but haven't announced it publicly yet. I'll be sharing next month. I do know this, you need not feel guilty about whatever you decide to do. This isn't about vanity. This is about doing what feels right for you. Believe me, I understand what you're going through as I've been going through similar emotions as I made my decision. I'm sorry you have to make these big decisions again. And so soon after your reconstruction too. Take some time to carefully think about all your options. Don't let yourself feel rushed or pressured. My best to you as you decide what to do.

Carol

Thursday 14th of November 2019

I am almost 11 years since my breast cancer diagnosis. I was 55. I had a bilateral mastectomy, chemo, radiation, and was her 2 +. I told my PS not to put in the expanders if my sentinel node was positive for cancer. He put them in, said he did what was best for me. I was angry about it for a long time, finally had to let it go. (Went to a different PS one year later) I had an implant rupture in 2013 and had it replaced. In 2017 I had another MRI and had folding of the implant. I found out 2 days ago that I have a ruptured implant. Oh the emotions that I have been through. I see the PS tomorrow and will find out his recommendations. Honestly I have enjoyed having a little cleavage. I have scarring on the breast that had cancer, and it is painful. I also have lymphedema and wear an arm sleeve with the most amount of compression. The last couple of days I have been a rebel and haven't worn my sleeve. Reading this blog has been very helpful for me. Thank you!