Should I Be Worried About Silent Rupture If I Have Silicone Breast Implants?
It’s no secret to those who know me that I am a big fan of silicone gel breast implants—as are thousands of our Berks Plastic Surgery patients. The latest generation of smooth, round silicone gel implants look, feel, and move just like a natural breast, and we can even choose the filling consistency to dial in your desired level of breast fullness with great precision.
In sum, today’s silicone gel implants can achieve a natural looking and feeling breast augmentation better than anything we’ve had in the past.
However, as fantastic as silicone gel implants are, they do not last forever. While extremely durable—a silicone implant can withstand hundreds of pounds of pressure—there is always a small risk that the shell will tear or rupture. With silicone implants, a shell rupture can be difficult to detect on its own, hence the term “silent rupture.”
What is silent rupture?
Unlike saline implants, which noticeably deflate if the shell ruptures, silicone gel implants will maintain their shape, and there is rarely any sign that the rupture has occurred. Silent ruptures are not considered medical emergencies, as the silicone filling is too thick to easily migrate outside the breast capsule into the body. In fact, most patients who have a silent rupture experience no symptoms or side effects. However, to be on the safe side and to prevent further possible complications, a ruptured implant should be removed promptly once it is detected.
Silent ruptures are usually not considered medical emergencies, and most patients experience no symptoms or side effects. However, to be on the safe side and to prevent further complications, a ruptured implant should be removed and replaced promptly once detected.
Typically, the only way to detect and/or confirm a silent rupture is through ultrasound or MRI imaging. The FDA recommends that patients with silicone implants undergo routine imaging to monitor for silent rupture, beginning three years after their breast augmentation surgery and every two years after that. It is up to the patient to schedule and receive these tests, although we like to send reminders to our breast augmentation patients on surgery anniversary dates to help them remember when it’s time for follow-up care.
How do I know when to get breast implants replaced?
Most breast implant ruptures, silent or otherwise, occur to due to natural wear and tear as opposed to a sudden impact; this is true both saline and silicone. Studies show that rupture risk increases slightly each year for the first decade, and then rises more quickly after the ten year mark. This is why many plastic surgeons, myself included, recommend that patients schedule follow-up visits with their surgeon every 1 to 2 years and consider replacing their breast implants every ten years or so, even if there isn’t a rupture or any other problem. This is an option whether or not you have undergone recommended MRI/ultrasound tests.
Upgrading your breast implants every 10 years or so is a great way to refresh your look, take advantage of the latest implant options, and reset the clock on the risk for silent rupture.
The benefits of replacing your breast implants every so often go beyond that of avoiding or detecting a silent rupture.
As I (not so subtly) hinted in the beginning of this post, the breast implant options you have today are better than what were available a decade ago, and are likely to continue improving. Additionally, your body and breasts change over time. Your aesthetic tastes may have changed too. Upgrading your implants before there is a “problem” is a great way to refresh your look, achieve a breast shape, size, and look that best matches your current lifestyle, and reset the clock on the risk for silent rupture.
Of course, if you are unhappy with or concerned about your breast implants for any reason, at any time, you should contact your plastic surgeon to discuss options for removing or replacing them. Whenever the time comes to replace your breast implants, be sure and choose a plastic surgeon who is very experienced in breast revision procedures. If you do have a rupture, your plastic surgeon should remove both the implant and the surrounding capsule (scar tissue) before replacing a new implant, a procedure known as en bloc breast implant removal.
Helping you choose the right breast implant option is our priority
About 98% of our Reading breast augmentation patients choose silicone gel for their breast augmentation, and close to 100% are happy with their choice! That said, our priority is helping you find the right breast implants to achieve the look and feel you want while also providing the peace of mind you deserve. Any FDA approved breast implant, saline or silicone, can meet these requirements, and we will be happy discuss both options at your breast augmentation consultation. Call 610-320-0200 or contact us here to learn more!
55 Comments Posted to "Should I Be Worried About Silent Rupture If I Have Silicone Breast Implants?"
Agree with this grate article, especially these words: “Upgrading your breast implants every 10 years or so is a great way to refresh your look, take advantage of the latest implant options, and reset the clock on the risk for silent rupture.”
Thank you for sharing, so much useful!
I had silicone implants 40 yrs ago. They have always been fine. This time my mamo- showed a leak. I went for an MRI and sent the results to my Dr. in NYC who did them for me for his advice. They said there was a leak and I should do something about it. Unfortunately I am no longer in the financial bracket as I was back then. At 74 yrs old I work to support myself. I live on that and SS. I could never afford to redo them again! I don’t think Medicare Ins. Covers old implants! Any suggestions? Will I die from this?
Thanks so very much.
Warm regards
Rita
Medicare will cover explanation and capsulectomy but not replacement. Seek out a plastic surgeon that accepts insurance and Medicare and they can help you. Good luck!
Like Rita, I am 78 years old and my last mammogram (1 week ago) shows that one implant is leaking. I had my breast augmentation in 1979 and was in a higher financial bracket. I had no clue this was happening until the radiology report. I do not know what to do. Is my health in danger, if I do nothing at this time (your best guess)?
Dianne
I would recommend evaluation by a board certified PS, Medicare would cover explantation if warranted
My plastic surgeon stated that the silicon will just stay inside the shell…
So, what is your opinion?
Must I have the ruptured implant removed?
Yes. Ruptured implants should removed. Sometimes insurance will cover explantation if you are have complications. Replacement, Breastlift or other revisions are typically cosmetic in nature
I’ve had implants in for 17 years and I’ve never been contacted regarding check ups now my right implant has leaked into my mammory glands but nobody is doing anything about it I’m now terrified and in huge amounts of pain as my breast keeps filling with fluid it was drained twice but now I’m just left in limbo and my breast is huge filled again what should I do ? Please
seek a consultation with a board certified Plastic Surgeon for treatment and explantation
My post mastectomy implants are 15 yrs old. In May,2020, my 1 implant had silicone leak which has migrated into my arm pit. I’m afraid to get surgery due to the Pandemic, but I recently had lab work which had a positive ANA.
i would recommend having the ruptured implant replaced as soon as you feel comfortable
I had a hard fall on the weekend and hit onto my left breast. I had silicone implants 30 years ago. My breast is very painful since the fall. There is no bruising. Should I have this checked?
yes. I would recommend an evaluation and either an MRI or hi-resolution ultrasound
Hi I had silicone implants placed 30yrs ago due to a severe pectus excavatum. I started having pain around my left breast an down my left arm. I went to the ER & a CT scan with contrast showed leakage / rupture of my implants . All the plastic surgeons I called for an appointment are booked out till at least May 2021 . How emergent is it for treatment? And also what happens to the silicone that is leaking into my body ?
It is not an emergency and honestly over 50% of the older 3rd generation implants were found to be broken at 10!! Years. Yours have been broken probably for a decade or more. It’s just now that you are having symptoms. Pick the surgeon you like and wait for the appointment. Good luck! And no worries
Hi, really interesting article. I had a breast augmentation 15 years ago, and last month found out my left implant has a rupture. I’m in the middle of IVF and wondering if I can move forward with pregnancy and take care of the implant afterwards or is this is an emergency and should be taken care of before continuing trying to get pregnant. Because of covid and other factors all plastic surgeons are giving appointments between 6 and 12 months from now. And I would prefer not to wait that long for an answer to my situation. Thank you
If you are currently pregnant then you should wait since anesthesia is not recommended during pregnancy. If you are not yet pregnant then I would have a replacement and seek treatment
Last year I took a terrible fall and landed on my breasts. I just had a CT Scan and this is what it showed:
“Partially
visualized right breast implant which has incomplete calcination of its outer
capsule. Numerous soft tissue nodularities throughout the visualized inferior
half of the right breast our suspicious for silicone granulomas from breast
implant rupture. This is new from previous exam. Partially visualized left
breast implant appears intact with no surrounding soft tissue nodules in the
fatty tissue of the left breast.”
Please tell me what you can deduct from this report and what should I do?
you should review the study with the doctor that ordered the test and be evaluated in person by a board certified plastic surgeon
I have implants that are 40 yrs old. (Back then it was thought that silico e would last forever, and there was no mention of having them checked periodically). I just recently learned that I have a rupture in the left. I’m dealing with other health issues now, and not ready to have THIS surgery. I have no pain, or other symptoms.My question is simple; should I be wearing a bra 24/7 to support the breasts until I’m ready to go ahead with the needed surgery?
Does not matter. Whatever is most comfortable. Seek a replacement when you are able
I am 3 months post op with cohesive gummy implants. I was assaulted 4 days ago and punched in my left breast and she grabbed it as hard as she could. Now my breast looks slightly uneven from my right. Should I worry or just leave it alone.
I recommend an evaluation by a surgeon and a high resolution ultrasound to evaluate the integrity of the implant
After mastectomy, I had silicone rt breast implant 2012. In Jan, 2021 I had coronary bypass surgery and approx. 2 wks later developed sepsis with staph aureus present. In March 2021 hospitalization they removed silicone implant due to a silent rupture. I was on IV antibiotics for many months I am still having some pain in rt axillary area, rt pectoral area and lots of extra tissue under arm . Is it possible that not all the the silicone has been removed? Can scar tissue be formed where implant was, causing discomfort? cultures now negative for staph and labs are normal. Plastic surgeon says not recommended to have further reconstructive surgery but I look quite bad and now need to wear prosthesis.
I would recommend evaluation at a University program that specializes in breast reconstruction. You are a complicated case and require a specialized care. Good Luck!
I had breast implants done 2 and a half years ago.
a year ago I felt a difference in my left breast. I had a MRI do and it shows no rupture but it feels less firm then the right. What do you suggest?
I recommend evaluation with your plastic surgeon.
I had silicone implants in 2008. Ive had no issues until July 2021 when I dove from a high dive board, heard & felt an internal “pop” in my left Breast and continue to feel “surging bolts” of pain not previously present yet continue for last 8 weeks.
Since September 2021 my left breast now hangs much lower than my right. My doctor ordered an MRI. Results shared today:
TECHNIQUE:
Multiplanar multi sequential MRI images of both breast obtained with and without intravenous Gadolinium, CAD analysis of dynamic enhancement kinetics evaluated.
FINDINGS:
Right breast: There is an intact right breast implant. There is no evidence for intra or extracapsular rupture.
Minimal breast parenchymal enhancement is identified. There is no dominant nodule. There are no areas of suspicious nonmass enhancement. There is no skin thickening or nipple retraction. There is no pathologic adenopathy of the axilla or breast. The chest wall is intact and unremarkable.
LEFT BREAST: There is an intact left breast implant. There is no evidence for intra or extracapsular rupture.
Minimal breast parenchymal enhancement is identified. There is no dominant nodule. There are no areas of suspicious nonmass enhancement. There is no skin thickening or nipple retraction. There is no pathologic adenopathy of the axilla or breast. The chest wall is intact and unremarkable.
IMPRESSION:
Unremarkable breast MRI, no evidence to suggest neoplasm.
BI-RADS Code 1: Negative
COULD THERE BE AN ERROR because my breast looks, feels (I can now push thru center of Left Implant) and is slightly painful for 2 months.
You likely broke the surrounding capsule. I would recommend an evaluation and surgical revision
Yes, I have read the above and feel more confused than ever! I have two ruptured silicone breast implants…but no pain or swelling or
deformity. I am not into having them replaced..and from everything I have read…there is no risk of cancer or problems in the future. it seems every single time a woman finds her implants are ruptured…it is common to be advised to have them removed. Due to Covid, increased infections in hospitals, etc..I am very reluctant to have them replaced at this time. Can someone PLEASE reassure me that it is safe to just leave them alone and not replace?
From what I have read…there just doesn’t seem to be a lot of danger….thank you! Louise
If you are not having a problem and the rupture is intracapsular then you are fine. For many women the gel does not cause a problem but eventually you will probably get a capsular contracture. Of the older generation of implants after 10 years there is a 50% chance they are ruptured.
I stepped down onto a metal chair which flipped and the back of it slammed into my left breast…my implants were put in about 47 yrs ago and have never been a problem other than some hardening. I instantly noticed the left one was no longer hard so I went to an ER, had a ct scan done, was told I had a partial rupture and to see a specialist. We are on a caravan trip with other RVers and the earliest appointment I could get is 4/4…I got considerable bruising and it’s a bit uncomfortable but no redness, no excessive swelling but am still concerned what might be going on inside between now and that appointment time.
This is not an emergency. Enjoy your vacation but you will need surgery to address it
Your article and subsequent questions and answers have given me so much relief. I have 36yo-under muscle silicone smooth breast implants.
Interestingly enough annual mammo and sono always demonstrated intact implants. A recent breast MRI with contrast did not even demonstrate any rupture only a papilloma (without atypical cells). Thank goodness the Breast Surgeon I went to insisted on an MRI implant specific – which detected left (encapsulated lesion) and right rupture scattered throughout. The surgeon is not available until January. I’m concerned. I’m also an RN. Thank you for any wisdom you can send my way.
they have like been ruptured for many years, you are ok to wait until january if you are not having any symptoms or problems.
What should really be done for silent rupture. Some says no need to remove but how do you know the rupture won’t spread to the lymph nodes later? What is best advice.
I always recommend addressing a ruptured implant. HiDef Ultrasound is a very effective and inexpensive way to monitor for silent rupture
I have had silicone implants since 1987 and in Sept, one began leaking from a scar underneath the breast. I am on Medicare so was told that they wouldn’t pay for removal so I have continued to bandage and help the remainder of the silicone to come out. Today, Jan 1 2023 it seems silicone is all out but I have a hard sore knot top of breast. Hopefully, this will not be harmful and I can just leave alone. Not worried about the breast appearance since no one sees it, only health issue. Have thought about going to er on a weekend to see if they would do something. I do have Atena supplemental,but here again understand that I would have to pay for care. Thanks for your suggestions.
ABSOLUTELY Medicare will cover your surgery. It is terrible that you were told that. Please seek a hospital based surgeon that participates in Medicare and have your ruptured implants properly addressed. Good Luck!!
I had a ct done do to my hiatal hernia and was told bil. Breast implants seen with calcification in the ct report my doctor did not tell me I saw it on my chart report should I be concerned I have no issues with them, they look great and feel great, I have had them for 30 years, i was surprised to see this on my report, sincerely Andy
yes, calcified, ruptured implants should be replaced. seek a PS who specializes in breast surgery. Good Luck!
A recent MRI to review palpable painful lumps reported intact implants but free silicone from a previous rupture. Implants were exchanged a year ago but no mention of a problem during surgery. Is it safe to leave as is?
If you are having pain and symptoms then you likely need the free silicone nodules removed. I’d seek consultation with a PS that specializes in complicated br ast surgery possibly a university program
I have just found out I have a breast rupture and they have only been in 6 years. Who should cover the cost?
the financial responsibility is mainly on you. With that said some implant companies offer warranties that cover the cost of the implant and sometimes a cash supplement. Ask your plastic surgeon to open a warranty claim
Hi, I just have a complete mastectomy due to cancer, and now I have to get silicone breasts, my question is. If the silicone leaks, do the insurance or/and Medicare will pay for the reconstructions since this reconstruction was done due to cancer?
yes. it is mandated by law that insurance will cover your reconstruction and any revisions or complications. Good Luck!!
I had both implants removed years ago and did not have them replaced; of course, both sides filled up with scar tissue and density. There was a leakage of silicone at time of removal, and recently, now years later, I am experiencing much discomfort and pain on my right side where the leakage was. Is this something that will eventually go away? I, too, am not in the financial position to afford surgery.
I would start with your gynecologist and a breast exam. Mammogram if you are not up to date.
I recently had a small fall, when trying to retrieve something across my car console. My knee slipped and I fell onto the console pretty hard. I felt an intense pain located UNDER my right breast…and now have a lot of pain underneath the breast. Like its my ribs. It even hurts to move my arm or pick up heavy objects. Could this just be musculoskeletal trauma, or have I ruptured the implant? They are 20 years old..Silicone. Would a rupture cause immediate symptoms of pain and soreness? I’m leaving on a trip out of the country this Saturday, will it be ok until I get back?
Hi Sheryl, It’s possible that the pain you’re experiencing could be due to musculoskeletal trauma from the fall, especially considering the location and the nature of your symptoms. However, given the age of your silicone implants and the intensity of the incident, there is also a possibility of implant rupture. While some ruptures can be silent and not cause immediate pain, others can lead to discomfort. It’s important to get evaluated by a healthcare professional before your trip to rule out any complications with the implant and to ensure your safety and comfort during travel.
I recently had a mammogram done & now my right breast doesn’t feel right. Under my breast area, it’s tender & sensitive to touch & when I lift my arm up, it feels like something is pulling, e.g. it’s capsule issues or a silent rupture of my Allergan silicone implants which I’ve had for about 14 years. What would you recommend as next steps? Getting an MRI done?
I recommend a HiDef Ultrasound and evaluation by a PS. 14 years is time to replace 🙂
I just discovered your highly informative site and would like your advice! In 1982 I had silicone breast implants implanted under the chest wall. Since then, I had a mastectomy in 1998 on the right breast with a saline implant. The left breast with the original silicone implant has not demonstrated any symptoms of a rupture, however the natural breast tissue is no longer intact and is sagging with aging and gravity. (or perhaps from multiple mammograms?)
Question: Is it prudent for me to visit a plastic surgeon if I don’t have any rupture symptoms? Do you know if Medicare will pay for an ultrasound? Like others, I can’t afford expensive imaging or reconstructive surgery, however as a nurse, I want to be prudent. Thanks in advance for your wise counsel!
Medicare and your secondary will, and are required by law to cover reconstruction of both breasts given your previous cancer diagnosis. Seek out well qualified reconstructive breast surgeon. Good Luck!