Breast implants are usually made of an outer silicone shell and inner silicone gel. These have different consistencies. The internal gel can leak out of the implant and this is known as an implant rupture.

The chances of an implant rupture happening increases as the implants age and is around 5-10% of the first 10 years after insertion.

Implant ruptures can lead to changes in the breast which are noticed by patients, such as swelling, pain and altered shape. However, some implant ruptures occur without any symptoms or changes and hence we are moving into an era of greater implant checks with ultrasound or MRI scans.

There are three main different types of rupture:

Gel bleed

In some patients, the filler material in the implant can leak through an intact implant shell. This happens when the filler material is small enough to fit through the tiny gaps in the shell, similar to car tyres that become flat even though there is no obvious puncture.

Intracapsular rupture

Breast implants, because they are foreign material, are walled off by the body in scar tissue. This is known as a capsule. Intracapsular rupture means that the implant shell is damaged, but the filler material is contained within the capsule. Most women with intracapsular rupture are completely unaware of this. Some may notice a slight change in shape of the breast or how the breast feels.

Extracapsular rupture

When silicone from ruptured implants spreads beyond the capsule, patients are usually symptomatic. There may be a change in breast shape, lumps you can feel, or redness of the overlying skin (inflammatory changes).

Breast implant problems

Having an implant rupture is not thought to be dangerous to an overall patient’s health. However, if the silicone travels to the axilla (arm pit) then it can cause some lumps which can be uncomfortable.

Very rarely, the silicone can travel beyond the axilla to the neck tissues. Treatment consists of removal of the ruptured implant, complete evacuation of any free silicone, removal of the capsule, and, if desired, insertion of a new implant.

Such surgery is not urgent but the longer the silicone is left in the tissues rather than in the implant, the higher the chance of it travelling to the axilla.

Breast implant problems, Capsular contracture
Breast implant problems, ALCL & BII