What Happens If You Leave a Ruptured Silicone Implant?

If imaging reveals a ruptured silicone implant, the bottom line is straightforward: a damaged medical device needs to be removed. It's not an emergency, but it's not something you should sit on forever, because the longer a ruptured implant stays in place, the worse the potential complications become.

You may feel fine right after the implant breaks, but over time the scar tissue around the implant can become thick, tight, and painful. This is a capsular contracture, and the worse it gets, the more difficult it is to treat.

Silicone can escape the cavity around the implant and migrate into the surrounding breast tissue. When this happens, the body creates an inflammatory response around the silicone, forming small firm masses called silicone granulomas. These can be scattered throughout the breast, and removing them, especially when there are many, can be very challenging and may lead to breast deformity.

The silicone can also travel to the lymph nodes in the armpit. In rare cases, this can block lymphatic flow and cause arm swelling. While this isn't very common, it's seen more frequently with older-generation implants that had thinner shells and more liquid silicone.

In severe cases, silicone granulomas, clumps of silicone, or a contracture can push the implant or silicone toward the skin surface. This can result in silicone oozing through the skin or visible openings where the implant is exposed. It's a terrible problem, and Dr. Killeen sees it a couple of times a year in her practice.

In one recent case, a series of doctors failed to recognize an obvious implant extrusion, sending the patient for unnecessary biopsies instead of referring her to a plastic surgeon.

Dr. Killeen doesn't expect primary care physicians to know how to manage implant complications, but she does expect them to recognize when something isn't right. A capsular contracture or an implant coming through the skin should be recognized and the patient should be referred to a plastic surgeon. Patients can choose what to do with that information, but the right thing is to tell them it's not normal and send them for help.

If you've been told you have a ruptured silicone implant, don't ignore it. Schedule a consultation with a plastic surgeon experienced in breast revision or implant removal to discuss your options and prevent these complications from developing.