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.)
- 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.
- 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.
- 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)
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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?
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