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Rupture within the first five years is very rare, but the possibility of rupture increases especially after 8-10 years of age. The percentage is very variable in the scientific literature and ranges from 2% to 7%, depending also on the type of implant.
When we say that an implant is ruptured, it means that there has been a solution of continuity in the envelope and the silicone comes out of the barrier. As the prosthesis is surrounded by a scar (the capsule), the silicone is contained within this space. When this occurs it is called intracapsular rupture. If the silicone comes out of this biological barrier and enters the surrounding tissue (muscle or gland), we are dealing with an extracapsular rupture.
Some publications recognize that implant rupture is more frequent when the implant is under the pectoralis major muscle. The mechanisms by which an implant may eventually rupture are not known exactly, but it is quite possible that friction, especially in areas with folds, may be the most plausible cause.
Sometimes we can find silicone in the axillary nodes (this is known as siliconoma). This silicone has been absorbed at the level of the capsule and moves to the nearest lymph nodes. It is a defensive mechanism, similar to that which occurs in infections or with cancer. The presence of silicone in a ganglion does not mean that it does not work and the current tendency is not to remove them. The siliconomas usually appear if the prosthesis is broken but in some cases the prosthesis is intact but there has been a leakage of silicone that is inside the prosthesis through the envelope, by diffusion.
It is necessary to perform a secondary breast surgery, similar to the breast implant surgery, but this time the objective is to replace the broken prosthesis. Actually, we will replace both implants since, if the rupture has occurred due to material degradation, the second implant must be replaced to avoid rupture. In any case the decision has to be individualized since it depends on the time that has passed since the original implantation.
In the intervention the implant capsule will be removed if necessary and possible and will be replaced by a new implant. If you do not want to have an implant again, we can infiltrate fat grafts (breast lipofilling) to give volume and that the breast is not completely empty. In these cases there is a volume halfway between having nothing and the implant.
All breast prosthesis manufacturers worldwide offer warranties for manufacturing defects ranging from 10-20 years to a lifetime warranty. But this does not mean that the implants must be replaced by others after this time if they do not give problems. Nor is it true that implants should be replaced every 7-8 years (or other figures that you hear or read). In our experience 7% of the implants may break in about 10 years. Nor can we be sure that the implant will last a lifetime. It is possible that during the woman’s life the implant will have to be changed at least once. That is to say that we can safely keep the prosthesis in our breasts until it is detected that there is a medical criterion to change them. It must be taken into account that most of the complications such as the aforementioned rupture, capsular contracture or seroma occur after several years.
Our price range for prosthesis replacement (from 6.000€) includes:
Follow-up and revisions during 1 year included: the revisions include an ultrasound study of the implant, something in which we are pioneers in Spain and we train the rest of the surgeons in the country.
4. Rupture and complications insurance: in case of rupture and capsular contracture you do not have to pay any cost in the first 5 years.
5. Fees and clinic: during hospitalization a companion can be with you at no additional cost.
6. Implant warranty: we work with the best implants in the market. With the implants we give you their cards that make reference to the quantity and material that you carry, and includes the guarantee of the company that manufactures them.
7. Prices without surprises: the price you are given includes everything that has been agreed upon, there are no surprises or later additions.
The result in breast augmentation is immediate, although we recommend waiting a few months to see the final result. During 3-4 days we recommend some rest, after this time you can usually lead a normal life, but you must avoid efforts or weights for 15 to 30 days, depending on the plane where the breast implant is located.
Some swelling is to be expected in the first month, which then decreases. We know that the volume between 4 and 12 months hardly changes although there is a reduction of the breast projection by 30%.
It is also normal to have alterations in sensitivity, especially in the lower part of the breasts. This sensitivity is going to recover and may take up to 1 year for full recovery. It is very rare to have a loss of sensitivity in the areola, but not impossible.
In general, we can say that there are no clear symptoms in an implant rupture. In some cases there may be a change in the shape of the breast or lumps in the breast, asymmetries or changes in its firmness.
If you suspect that one of the bags has ruptured, you should make an appointment with your plastic surgeon, who will perform a breast ultrasound. In our hands we can diagnose a rupture with this system in 95% of cases. If a rupture is observed, he may recommend an MRI to better understand the extent and details.
Given the absence of symptoms, it is necessary to have a revision of the silicone implants every year or two years to check that they are still in perfect condition.
There is no relationship between rupture and breast cancer. To date, no significant relationship has been found between implant rupture and autoimmune or connective tissue diseases, so rupture is not considered a threat to women’s health.
Once it is known that the implant is ruptured, surgery must be scheduled. However, it is not an emergency. It can be deferred for a while. It is best to discuss it with the surgeon.
