Cohesive Silicone Breast Implant Ruptures

By Jerome Edelstein, MD

A patient who has breast augmentation surgery should be informed that silicone breast implants do not last forever and that implant rupture can occur, although their incidence is rare. Once an implant has been properly diagnosed as having ruptured, it should be removed and replaced if desired.INTRACAPSULAR BREAST IMPLANT RUPTURE VS EXTRACAPSULAR BREAST IMPLANT RUPTURE

When an implant is placed inside the body, a capsule of scar tissue naturally forms around it. An intracapsular rupture involves the cohesive gel of a ruptured breast implant remaining within the confines of this natural scar tissue.

When the cohesive gel extends outside of the scar tissue capsule, it is known as an extracapsular rupture. Intracapsular ruptures rarely evolve into an extracapsular rupture.

Because it is often difficult to determine whether a silicone breast implant has ruptured because of the cohesive nature of the silicone filling, physical examination, mammogram or ultrasound are some methods to identify implant rupture. However, Magnetic Resonance Imaging (MRI) is the best method for detecting rupture of silicone breast implants, according to the FDA.

According to Health Canada and the Canadian Expert Advisory Panel, the process for determining the integrity of implants should be linked to clinical signs and symptoms. If you’d like to check to see whether your silicone breast implants are still intact, follow these 5 steps:

Self-examination

The appearance of new symptoms

A physical examination performed by a doctor

Mammogram or ultrasound

MRI is required if ultrasound is negative but a rupture is still suspected (a radiologist should read the MRI)