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Silicone Breast Implant Deflation – How Do You Know?

Picture of DR. SCOTT THELLMAN
DR. SCOTT THELLMAN

Board-Certified Plastic Surgeon, M.D.

Silicone implants have been in use since the 1960’s and have changed considerably over the years. 

Today’s implants are more have a more durable outer shell, have a more cohesive (“gummier”) silicone gel inside, and don’t fail as often as the older ones.  Still, any device placed in the body is subject to wear and tear over the years and can fail.  It happens with artificial joints, pacemakers, etc. and implants are no different. 

While most implants WON’T leak, it is a known potential complication.   

Unlike saline implants which rapidly lose volume when they leak and are obvious, a leaking silicone implant is much more subtle.  The silicone, especially in the newer implants, generally sticks together and is largely contained by the collagen capsule which has formed around the implant over the years. So how do you know if an implant has leaked?

Here are the most common symptoms that bring patients to our office:

  1. A change in the firmness in the breast. – A breast that has always been soft but starts to become firm could be a developing a capsular contracture which is a scar like reaction around the implant. The body is reacting to the silicone and containing it, a normal response. 
  2. A change in the appearance of the breast – Related to a capsular contracture, there may be a change in the size or shape of the breast.
  3. A new pain or sensation in the breast.
  4. Abnormal mammogram or ultrasound.

None of these mean the patient has a rupture but they should raise that concern.  The best test to look for an implant leak is an MRI, and we typically will order one if the patient has these symptoms.  This will usually diagnose an implant rupture if one is present but even this is not 100% accurate. 

For many, the most common symptom of a leak of the newer implants is none at all.  We’ve operated on several patients over the years and discovered a leak of a silicone implant that was entirely asymptomatic. 

The silicone leaves the shell but doesn’t go anywhere or cause a response.  The significance of these “silent ruptures” is unknown. 

If you have a concern that you have a leak in your silicone implants we’d be glad to discuss this with you during a consultation. 

Next:  Removing silicone implants