Plastic Surgeon in Brisbane, Dr. Phil Richardson explains the ins and outs of breast implant rupture in this tell-all blog. Keep reading to learn everything you need to know about this important topic!
Silicone breast implants have been in use for nearly 60 years. The first breast augmentation mammoplasty was performed in 1962 using a silicone breast implant, paving the way for countless operations to come. Over the decades, significant improvements have been made to implant technology. There is still consistent scrutiny surrounding the safety of breast implants, and improvements are continually being made to reduce the risk of implant-related complications. Regardless of technological advancement, complications are an inherent risk of any surgery.
While rare, breast implant complications are an important topic to understand. One complication that almost all patients of breast augmentation mammoplasty are aware of is implant rupture. Breast implant rupture refers to the breaking of the shell of a breast implant. Implant rupture often does not cause a gel leakage but in rarer cases, gel may leak out of the implant. This blog post aims to provide patients with all the information they need about implant rupture. We’ll discuss the causes, symptoms, health implications, and treatment options.
What is breast implant rupture?
Breast implant rupture refers to damage to the shell of the breast implant causing an opening. The complication is most commonly classified as either intracapsular or extracapsular rupture.
Intracapsular rupture refers to an instance where the breast implant gel is contained within the capsule of the breast. This means that the gel remains in the scar tissue surrounding the breast implant.
Extracapsular rupture references the instance where breast implant gel travels outside of the breast capsule. It can extend to surrounding tissues that can create a reaction and scar formation.
Causes of breast implant rupture
Breast implant rupture is a risk of breast augmentation mammoplasty surgery, and can happen at any point post-operatively from a few months post-op to decades down the track. What causes breast implant rupture? There are a number of factors that may contribute to this complication.
Damage from Surgical Instruments
One of the most cited reasons for breast implant rupture is intra-operative damage to the implant caused by surgical instruments. This is an avoidable cause of implant rupture and is a key reason you should ensure you choose a fully qualified plastic surgeon in Brisbane to perform your breast augmentation mammoplasty surgery. Why a plastic surgeon? Plastic surgeons have operating rights at fully-accredited hospitals, and work alongside a consistent team of scrub nurses and surgical assistants that have the correct training to prevent prosthetic damage.
Plastic surgeons operate under stringent guidelines and have thorough processes in their operating hospitals. These processes ensure sterility and integrity of the breast implant prior to implantation and during surgery. According to Handel, Garcia & Wixtrom (2013) over 50% of breast implant rupture is a result of damage caused by surgical instruments intra-operatively.
Capsular contracture
Another factor that can cause implant rupture is capsular contracture. Capsular contracture is a complication itself and refers to a hardening of the scar tissue surrounding the breast implant in one or both breasts. The scar tissue can tighten and squeeze the implant resulting in progressive hardening, distortion, and deformity of the breast. Severe capsular contracture can cause secondary implant rupture due to the increased pressure on the implant.
Compression during a mammogram or damage during biopsy, fluid drainage
A rarer cause of this complication is during a mammogram or breast exam involving a biopsy or drainage of fluid. Any of these devices may cause either extra pressure on or puncture of the breast implant, resulting in a rupture. This is uncommon however as most technicians have experience with implants. You should always confirm with your technician prior to any breast scans or procedures that they are aware of your breast implants.
Normal ageing of the implant
General ageing of the breast implant can contribute to this complication. Folds in the implant over time can rub together and eventually create a rupture. The integrity of the implant can weaken over time or the conditions in which the breast implant sits can change and cause irregularities in the implant position that can foster a greater risk of breast implant rupture. The level of risk associated with rupture over time will depend on the type of breast implant, and numerous other factors.
Physical trauma or pressure to the implant
One of the most well-understood causes of breast implant rupture is physical trauma to the breast. This can be as a result of any events that cause increased pressure on one or both implants. In general, implants are able to withstand a significant amount of physical pressure. However, breast implant rupture may occur due to the positioning of the implant, the angle of trauma, and more.
Symptoms of Breast Implant Rupture
Occasionally when a silicone gel-filled implant ruptures, a woman may notice a decrease in breast size, change in breast implant shape, hard lumps over the implant or chest area, an uneven appearance of the breasts, pain or tenderness, tingling, swelling, numbness, burning, or changes in sensation.
It is more common in silicone breast implants for symptoms to be “silent”. This is due to the silicone gel most commonly staying in tact within the breast capsule due to the cohesiveness of the gel. “Silent rupture” refers to a rupture that produces no noticeable symptoms or changes in the breasts.
Detecting Breast Implant Rupture
Given that the complication can often be silent and present no symptoms – how can we know when this occurs? Patients with implants should have routine ultrasounds to check for the complication. Ultrasounds are able to detect any irregularities in the breast implants and will confirm the integrity of the implant. In some cases, an MRI is needed to confirm breast implant rupture.
Patients with breast implants should have routine ultrasounds once every one to two years, or according to the recommendation of their operating surgeon. Clinics such as the BRAS clinic in Brisbane provide bulk-billed breast implant review services that also provide ultrasound referrals to patients.
Health Risks of Implant Rupture
One of the most common questions patients have regarding this complication is “how serious is it?”. The implications of rupture on the safety and health of the patient is an important topic to understand. A Danish study conducted over a two year period found that there was no increased levels of antibodies for both intra and extracapsular rupture. This suggests ruptured implants have no discernable health risks. This is consistent with broader research which has found that implant rupture poses no discernible health risks to patients aside from symptoms they may experience such as pain, tenderness, swelling, and more.
How to treat breast implant rupture
When patients present with this complication, they have two options: surgery or observation. Replacement of breast implants is recommended to patients who are experiencing adverse symptoms as a result of the rupture. While rupture does not pose any immediate risk, patients may wish to alleviate the symptoms and rectify any aesthetic changes. Implant removal with full capsulectomy is generally required for patients with implant rupture, meaning the full breast implant capsule is removed with the implant.
A “wait and see” approach may be best for patients who aren’t experiencing symptoms. This involves periodic observation through review and ultrasounds. This option is mostly up to the patient to decide when they would like removal or replacement of implants.
Conclusion
Implant rupture is a complication that almost all patients with breast implants know about. While it is well-known, it is not well-understood. This blog post provided information about what implant rupture is, what some of the main causes and symptoms are, the health implications, and treatment options. If you have any questions about this blog post or breast augmentation mammoplasty surgery in Brisbane, contact us today.