What if your breast implant ruptures?

What If Your Breast Implant Ruptures?

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.

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

Let’s talk about it.

Note: Much of this info 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?

  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.

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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?

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

24 thoughts to “What If Your Breast Implant Ruptures?”

  1. Hi there. Nurse of 37 years here, and breast cancer survivor. Did you know that not all implants are silicone? Mine are saline, and when one ruptured, the ONLY symptom was a flattened breast. It happened overnight. Sometimes these events are very painless and subtle.

    1. Julie, Yes, all implants are not silicone. I tried to cover that via the links, but perhaps I didn’t make that clear enough. Thank you for sharing about your rupture. You’re right, sometimes these events are quite subtle, at least at first.

  2. After my mastectomy I used a prosthesis for six months while I did research, I did not want an implant however I knew I had to do something because the prosthesis was very uncomfortable and I was very self conscious.
    I chose to have the DIEP Flap surgery and am very glad that I did. I do have a big “football” shape scar on my breast but once I got a nipple tattoo the “football” didn’t stand out so much anymore. Recovery from the DIEP flap surgery is tough but well worth it, I’d do it again over using a prosthesis or having an implant.

  3. Well, this has given me one more thing to think about as I’ve never given much thought to the possibility of a rupture. What if one ruptures? Do you go around with one flat side until you are able to repair the damage? And just what does that involve? What is the average number of years they are good for to begin with? I don’t remember discussing this with my reconstructive surgeon and he’s moved his practice across the country now. I would really feel lost, and it would feel like losing my breasts all over again although nothing will ever compare with the first time. Ugh.

    1. Donna, If you have saline implants, the rupture might be quite noticeable right away. If you have silicone implants, a rupture can be subtle and go unnoticed – that’s the silent rupture and the reason for MRIs. Every situation is different and every plastic surgeon has opinions on followup after initial placement that they recommend. The FDA guidelines aren’t necessarily what they all follow. If you are feeling lost, it might be worth talking with a new PS to get an opinion on whether you should have an MRI or not. You can also just wait until you have symptoms – and you might not ever. Generally, implants are expected to last around 10 years, but there isn’t complete agreement on this either. You should do whatever you feel most comfortable doing. I gotta say, my rupture has stirred up a lot of those feelings you mentioned. Thank you for commenting. I hope this post is helpful, not stress inducing!

  4. WOW…I had no clue that a follow-up MRI was recommended at the 3 year post-implants mark! My surgeons never mentioned that, nor has my oncologist. My 3 years is coming up in 5 months, on 12/7. In all honesty, as emotionally difficult as I imagine it will be, I am feeling some relief as an MRI may not only show any changes in the implants, but also in the surrounding scar tissue. It freaks me out a little (!!!) that the only follow-up I have received from my oncologist every 6 months is a manual exam around my implants and lymph nodes and asking whether I’m experiencing any pain. Um…I wasn’t experiencing pain at the time of my stage 2B cancer diagnosis nearly 4 years ago, so who’s to say it hasn’t made just as stealthy of a return?! Another cancer “gift that keeps on giving”: the fear of recurrence. UGH!! Thank you so much for this timely post, Nancy; I see my oncologist later this month and will definitely be discussing this with her.

    1. Cathy, As I mentioned to Donna, not all PS agree with or recommend following the FDA guidelines. I know what you mean about those followup exams. My oncologist doesn’t even do an exam like yours does. Good luck at your appointment. It’s likely your oncologist will refer you to your PS for followup concerns about your implants, but definitely ask. Thank you for reading and taking time to comment too.

  5. I had reconstruction with implants since the surgeon said she didn’t think I could handle a 12 hour surgery for the flap. Except for waiting 8 months with the uncomfortable tissue expanders through chemo and recovery things went well. I can only do water aerobics for exercise and didn’t want to deal with forms.

    Then not a rupture, but capsular contracture. After reading about capsulectomies online, I asked the plastic surgeon if he could just remove everything and make nice flat scars. He thought replacing the one implant would be easier. I’m so glad I did. There were no drains and not much pain.

    1. Pat, I’m glad you mentioned capsular contracture, as that’s another situation that can arise with implants. I’m glad to hear your replacement surgery went well and that you had little pain. Thank you for sharing your experience.

  6. Six months after the mastectomy of my right breast and not finding any prosthesis that felt or looked right, I researched reconstruction. I decided on the diep flap reconstruction precisely because of implant failure and that studies showed that older BC patients (I’m 68) were much happier with autologous reconstruction than implants. Yes, it isn’t an easy reconstruction, but six months post the first surgery I’m so glad I made the effort. I was encouraged at my preop exam when the nurse said her mom had a bilateral mastectomy with immediate diep flap and three years later she was thrilled she did it. I asked how old she was when she had the surgery and the nurse said 70! She smiled and said “you’ll do fine.”

  7. Oh, Nancy, I am so sorry you are going thru more crap!
    I just had an MRI and NO way is it fun, I can attest to that. I’ll be demanding a pill to relax me next time,
    ( I have to do it again in 4 months 🙁 ……gulp.)
    And that is quite an eye opener about implants, thank you for sharing your personal story with us.
    Who would have known? I learn so much here! From you and all your dear readers.
    I don’t have them, I had a lumpectomy aka partial mastectomy and I got to keep most of my parts, just lost 4 nodes and 2 scoops.
    But I always wonder what I would do if I had to choose implants or stay flat.
    As more time goes by and more info from real ladies with real experiences is made known…….
    lots to ponder………
    There seems to be so much we are not told about the fallout……… The following years after……
    what to expect the rest of our lives………………….
    And that really sucks that you now have to think about more surgeries and more worry.
    Yes, take your time and don’t feel pressured. ha…..
    It is truly a huge decision……remember to take your own advice!
    But I sure know that feeling of “get this damn thing out of me!”
    And just know that we are all here to give you any support you can use!
    And please keep keeping it real………………………

    1. Tarzangela, Thank you for your kind words of encouragement. And yes, sometimes I do need the reminder to take my own advice! Ha. I do intend to take my time this go around. But then, I wonder if it’s that’s just another form of procrastination. Oh well. So be it.

  8. I also had capsular contracture, 3 1/2 years after my reconstruction. I had the implants placed under my pectoral muscles, and the PS said that they didn’t place them there anymore since the aloderm now comes in larger sheets (or something like that), and the muscle rubbing over the implant seems to cause more cases of contracture. I went in prepared to ask for them to be removed and have nice flat scars, but he convinced me that the implants have improved, and the chances of contracture are much lower now. I decided to go ahead and swap out the old for the new. It was another surgery with drains, about a week of really tough recovery, but carefully eased back into life after that. I have to say, I felt instant relief from the “iron bra” feeling – I noticed it was gone as soon as I woke up in the recovery room! But now I do need to wear a bra again, after 3 years without.. or I feel sore where the aloderm is attached. So far so good, but if I get contracture again, I am having them out, and going comando.

    1. Jennifer, Just to clarify for everybody, capsular contracture is different from a rupture, which is the focus of this particular post. More info about the first can be found here: https://www.plasticsurgery.org/news/blog/what-is-capsular-contracture-and-how-can-it-be-treated I’m glad to hear you found instant relief after the exchange. Hopefully all will be good for years to come! Thank you for sharing about your experience and by doing so, helping others.

  9. I want to speak up for women who have chosen not to have reconstruction. Many women, like myself, are content with their decision to “go flat”.
    I decided to opt out of reconstruction pretty early on. Back in 98 when I had my initial diagnosis, my friend’s mom had implants and within a year and a half she had 3 ruptures. You heard right, THREE! She never did get an answer as to why her implants kept failing – just bad luck I guess. Or maybe back then it was a quality issue. In any case, her experience was enough to scare me off of implants.
    I won’t lie. As the years progressed there were times when I regretted my decision. It’s no fun being lopsided and a prosthetic just doesn’t cut it when it’s only on one side. So when my second diagnosis occurred I seriously considered implants. I was pleasantly surprised when the surgeon didn’t suggest that reconstruction was necessarily the way to go. That’s a real switch from all those years ago when it was automatically assumed that you were going to go under the knife. He told me to think about it while I was healing and if I decided to go for it we could discuss options. During the weeks that followed I became really comfortable with my body and actually enjoyed the feeling of not having to wear a bra or prosthetics. I researched as much as I could and considered both the success stories as well as the failures. Always at the back of my mind was my friend’s mom and I knew that, for me, I’d always be thinking of her experience and wondering, “is this the day my implants are going to rupture? Do I really want to deal with that worry for the rest of my life”? The answer for me was a resounding “no”, so I opted out of surgery. For me it was the right decision and I haven’t regretted it.

    1. Lennox, Thank you for sharing the route you took. I’m contemplating that one myself. It’s such an individual choice. All choices must be presented and all choices honored. I sense a bit of judgment, though unintentional I’m sure, when the various options/choices made are discussed. I don’t mean here on this post, but around the internet, which is to be expected, I suppose. Thanks again for sharing. Glad you have no regrets. In the end, that’s all that matters.

      1. Nancy, thank you for today’s post and for this post. It connects deeply with me. I am sorry that you are having to think about “decisions” again. Thank you for speaking up gently about unintentional judgement around the internet. I have had to pretty much stop all “looking” because being an implant decision maker definitely does not get positive light out there. I was having major anxiety over my decision and drowning in a dark hole every time implants were negatively spoken about. Thank you for educating me about implant complications with this post. Most helpful for me and gives me a few more questions to ask my PS tomorrow at my appointment. Deflating because the last inflation was a little bit to much. Haha. My friend calls me “deflate-gate”. Haha. Thanks for all you do in this community.

        1. Ruthann, I’m glad this post resonated. Unfortunately, there is a fair amount of judgement out there, unintentional or not, regarding reconstruction choices. Such is the world we live in. Hope your appointment went well. Thank you for reading and for commenting too.

    2. Thank you for speaking up on the choice of going flat. I won’t bore you with all my details but I do think if I have to make a choice again I will go flat. I don’t mind my implant at all (unilateral) right now. But i think flat could be a good choice for me if I need to make it in the future. Thank you for sharing!!!

  10. 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!

  11. 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.

    1. 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.

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