How long does a breast implant last?
Knowing if your breast implant is ruptured or not concerns many people who have had cosmetic breast enlargement or breast implants for breast reconstruction. The best modern breast implant is far more durable than first or second generation devices from the 1970s and 1980s, but the rupture rate is know to increase with time. The best studies on breast implant rupture are MRI studies where the breasts were checked every few years to determine the rupture rate. This shows the rate to be around 10% at 10-years. Do not confuse the ‘lifetime guarantee’ provided by the implant manufacturer for implant rupture with this known fact on rupture rates! Implant manufacturers are NOT saying their implants will last for life! They are saying they will give you a free replacement silicone implant if your implant ruptures. That is all. They will not pay for your revision operation. There is more information on the breast implant guarantee on my web site page on breast augmentation. Sadly I have heard many patients who are duped by practitioners and clinics playing on the wording of this guarantee to lure customers to their practices by pretending they are using an implant that is of superior quality to that available to any one else. Please do not fall for this deception and always see a certified and accredited specialist who does this surgery at the most reputable hospital you can find such as the Leeds Nuffield and the Leeds Spire hospitals (both are Care Quality Commission approved as outstanding or excellent!). Find out more here.
How can I tell if my breast implant is ruptured?
If you have no symptoms at all, it is unlikely that even a specialist like myself will detect that a breast implant is ruptured during a clinical breast examination. What I look for are positive signs that suggest rupture, but the lack of findings does not rule out implant rupture. I examine thousands of breasts and am very used to the subtleties of different breast problems. Despite this I cannot detect rupture unless the signs are present or a complications has occurred. The absence of signs does not mean it is not ruptured and we refer to this as ‘silent rupture’. This is more common than you think! I therefore evaluate asking about the history of previous problems and the current concern, implant type, where and when it was placed and by which surgeon. It is important to know about pregnancies and breast feeding, previous mammograms, any injuries or trauma, any family history of breast cancer, any symptoms or signs on examination. I will always evaluate the breast for the possibility of other problems at the same time, particularly any signs suggestive of breast cancer. I will also always examine the local lymph nodes in the axilla.
Breast Implant Is Ruptured -clinical signs
What signs do you look for that might suggest rupture? Any changes should be considered.
- Implant goes soft: An implant that has become a lot softer might indicate the gel has leaked.
- Implant goes hard: Sometimes the opposite happens, and the breast can become hard due to capsular contraction developing around a rupture.
- Breast becomes swollen: On other occasions the breast will swell very dramatically and look noticeably bigger and more rounded as a significant volume of tissue fluid (plasma) forms around the implant. This can be caused by lymphoma (BIA-ALCL) too, so any swelling must always be investigated by a specialist.
- Lump in breast: A hard nodule or thickening in the breast should always be considered as a potential breast cancer and investigated in a specialist breast clinic by a specialist, to determine the cause. A leak of silicone into the breast tissue can feel just like a breast cancer, and a breast cancer can feel just like a leak of silicone. So the only way to be certain is to be seen by a specialist, and to have the appropriate tests. This may involve breast imaging and a biopsy. Sometimes the lump needs to be removed or monitored.
- Lump under the arm: A lump or thickening under the arm is likely to be an enlarged lymph node or cluster of nodes. Most of the time this will be benign reactive nodes, but specialist investigation in a breast clinic is mandatory to exclude breast cancer that has appeared in the arm pit nodes (this can happen before it is felt in the breast). Silicone in the lymph nodes might indicate a leak from the implant, but it can occur with rupture where silicone has bled through an intact implant shell.
- Pain, Itching or Other symptoms: Any new symptoms or signs that fail to resolve should be considered and evaluated with further tests.
Investigating for signs that your ‘Breast Implant Is Ruptured’ with an MRI Scan
MRI report example: “Breast implant is ruptured. Positive linguine sign seen on right implant. No evidence of extracapsular silicone”. MRI is considered the best test to check for implant rupture. However it is not 100% accurate. Looking at results from lots of studies (meta-anlysis) reveals MRI sensitivity of detecting rupture to be around 78%. The MRI will usually show the characteristic ‘ linguine sign’ which is where the breast implant contains multiple curvilinear strands crossing over each other. But it is a time consuming test and it is expensive. In the private sector if you do not have medical insurance, it is often too expensive for patients, usually costing over £600 to £1000 for just the test and a report. In America, a baseline MRI is advised 3 years after implants are placed and then every 2 years, but I am not aware how many patients take this up and it is not a common practice in the UK.
Investigating for signs that your ‘Breast Implant Is Ruptured’ with ultrasound (USS)
USS report example: “Breast implant is ruptured. There is folding of the elastomer shell, and signs of collapse of the elastomer shell. There is a silicone granuloma in the adjacent breast tissue”. Ultrasound is a quicker and less expensive test than MRI, that is more commonly performed in the breast clinic, and always by a breast radiologist or specially trained breast radiographer. It is used more frequently than MRI to check the integrity of implants. Overall, it is the second best way of checking for implant rupture. The skill of the radiologist affects the accuracy. It still costs £200 to £300 so it is not commonly requested in the private sector if patients do not have medical insurance unless the patient is willing to pay for a test that is less accurate than MRI. Whilst a normal ultrasound is reassuring, it has to be remembered that the ultrasound may have simply failed to detect any signs of rupture at that scan.
Mammograms to check if your ‘Breast Implant Is Ruptured’
If you suspect implant rupture you should not undergo a mammogram unless there is an overwhelming medical reason to do so and it has been recommended by a Specialist Breast Surgeon. You should usually first have other tests by a breast specialist. Mammography is not a useful way to evaluate the implant; the mammogram cannot see the integrity of structures within the implant. Mammograms may show extracapsular silicone changes in the breast tissue surrounding an implant.
Be aware that if you have ever previously had a ruptured implant where silicone had migrated into the breast tissue it will have probably been left there even when you had your implants replaced i.e. that old silicone will still be in the breast tissue as surgeon’s would not normally try to remove it. When you next have a mammogram it will be reported as showing silicone in the breast tissue. The report might even suggest your implant has leaked because they see this silicone in the breast tissue- but unless you or the radiologist already knew it was there to start with from your old ruptured implant, you may be incorrectly concerned that your new implant has leaked!
Surgery to check if your ‘Breast Implant Is Ruptured’
In some cases, specific symptoms and signs may give suspicion of rupture but a diagnosis cannot be made from breast imaging. If the implants are around the 10 year age mark, you might consider exchange surgery anyway. This renews your implants and allows the surgeon to check the state of the old ones and see the appearance of the capsule.
Conclusion
The rupture rate of modern generation breast implants is around 10% at 10 years as determined by MRI studies The majority of ruptures are silent in nature. Implants do not last forever and you should always investigate any changes in your breasts or armpit. Those investigations should be done by an experienced specialist breast surgeon. The difficulties and consequences of dealing with a ruptured implant are usually greater than the simple process of renewing intact implants. It is not advisable to simply wait for signs of rupture before renewing breast implants and Mr Turton recommends to his patients that they consider renewing their implants at the 10-year mark if they have not had any earlier problems, as this is a safe practice. This is where you can find out more about implant https://cosmeticbreastsurgeon.co.uk/implant-exchange/. Otherwise you should consider breast imaging with MRI as a screening tool in line with the recommendations in America.
