You may notice shape changes, pain, or deflation.
To a large extent, breast implants are a “set it and forget it” type of decision for most women. After that, you basically live off the boost in confidence and the renewed feminine silhouette for many years. And sometimes to the point where you even forget that you have implants. However, from time to time, a sudden pain, an alteration in the shape or an odd feeling might cause you to panic. You look in the mirror, poke your breasts, and say, “Is this normal or do I have something internal broken?”
The answer to “How do I know?” largely depends on what kind of implant you have (saline or silicone) and how long you had the surgery. Although present-day implants are extremely resilient, they are man-made medical devices, not human organs. They do have a limited lifespan, and similar to a knee replacement, they are exposed to ordinary wear and tear. The symptoms indicating danger can be so obvious that one breast would completely deflate, or so obscure that it would require an MRI to find a “silent” silicone leak. Here at Lin Europe Clinic, we are convinced that a well-informed patient is a safe patient. Understanding when a pain might be a symptom of a surgical emergency can indeed save both your health and your beautiful assets.
The Deflating of a Saline Implant – An Immediate and Visible Sign
In case you have Saline Implants (silicone shells filled with sterile saltwater), it’s almost always crystal clear and sudden when something goes wrong. A tiny hole can develop in the shell due to fatigue of the folds or malfunction of the valve, and the fluid gradually leaks out of the implant and into the body. Since your body absorbs saline naturally and it is a harmless substance, this type of leak is not dangerous but still gives a visual shock.
One breast is going to visibly deflate during a matter of days, or sometimes just overnight, and will look like a flattened balloon or a wrinkled sack. There will be an evident loss of volume on that side to such an extent that your breasts will no longer be symmetrical: instead of two D-cups, a D and an A will be the situation. There is no room for speculation in this case – your saline implant has definitely burst if you discover one of your breasts is only half the size of the other after waking up.
A “Silent Rupture”: The Hidden Sign of Silicone Implant Damage
Silicone Gel Implants are much more difficult to detect without medical equipment. The implant gel used nowadays is so thick and cohesive (it’s sometimes referred to as “gummy bear” gel) that the breast won’t deflate even if the shell breaks, as gel does not leak out. Such incidents are referred to as “Silent Ruptures.”
In fact, the presence of a ruptured silicone implant can go unnoticed for several years since there would be no breast changes in appearance nor in touch. However, it is crucial to know that the gel can leak either in an “intracapsular” (the gel leaks out of the shell but is safely trapped inside the scar tissue) or “extracapsular” rupture (gel leaks into the breast tissue). The former is symptom-free and this is the reason why the Food and Drug Administration and plastic surgeons advise getting an MRI or Ultrasound with high resolution 3 to 5 years post-op and then on a regular basis every couple of years. If you perceive your breast shape has changed or you can touch a new lump or “knob” near the implant, it means that the gel is probably migrating, and in that event, do not hesitate to contact your plastic surgeon.
The Hardness Test: Capsular Contracture
Contrary to what most think, the common long-term problem isn’t due to a rupture but rather to capsular contracture which results from the capsule of scar tissue that naturally forms around the implant becoming abnormally thick and tight, and thus exerting a squeezing force on the device (hardening). This can happen if a “biofilm” is formed; this is a layer of bacteria which grows on the implant and that the immune system reacts to chronically.
Plastic surgeons grade the severity of the condition using the Baker Scale.
- Grade I: The breast is soft and looks and feels natural (Normal).
- Grade II: The breast is slightly firm to the touch but it looks natural.
- Grade III: The breast is firm to touch, the implant is positioned higher than usual on the chest, and the shape is either round or distorted (like a ball) (Visual recognition).
- Grade IV: The breast is hard, cold, distorted, and physically painful. Your chest can undergo quite a radical change from an initially soft shape to a high and hard bump that hurts if you want to hug somebody. It indicates that your body has been thrown out blood, whereas the implant itself is unbroken. The body is busy opposing the space occupied by the implant.
Visual Alarms: Rippling and Double Bubble
Aesthetic deformities may be the first clue to a patient that the implant and soft tissues are no longer in harmony. Two of the most common concerns regarding issues experienced by patients are “Rippling” and “Double Bubble.”
Rippling constitutes the appearance of creases or lines on the breast`s skin, as if the breast cover had deflated. Most of the time, it is a sign that your skin has weakened over the years due to getting older or losing weight, thus, the implant’s surface is shown to the naked eye.
However, “Double Bubble” happens when the implant is out of position under the inframammary fold, the natural crease of the breast. It looks as if there were two mounds stacked on top of each other. Although they are certainly not ruptures or infections that are medical emergencies, they clearly indicate that the internal supporting structure has failed. In fact, such problems confirm that the device itself is not compromised, but the result is, and the only way to restore a smooth contour would be to have revision surgery.
Late-Stage Swelling: A Warning Flag
One of the symptoms you should never turn a blind eye to is sudden swelling even years after surgery. If one of your breasts considerably increases in size, becomes fluid-filled, or red and warm, please bear in mind that none of these signs stand for a normal condition and you should first and foremost seek medical attention.
Fluid collection or Late Seroma or an infection may be suspected in such an event. If the implant features a textured surface, fluid around it can be associated with BIA-ALCL (a type of lymphoma which can be cured and which is in some cases connected with breast implants) – even though such occurrences are extremely rare. Nevertheless, any sudden breast enlargement that cannot be explained by a change in weight, pregnancy, or menstruation should be immediately followed by an ultrasound and fluid aspiration in order to exclude the presence of serious conditions.
Diagnostic Care in Turkey
At Lin Europe Clinic in Turkey, we don’t only do surgeries; we take care of the results as well. Should you feel uneasy about your implants, we offer a detailed “implant health check” to both our existing and new patients. We rely on high-resolution ultrasound which allows visualization of the breast pocket without a single incision.
The apparatus enables us to check the condition of an implant shell as well as the surrounding scar tissue and any fluid accumulation that may be present. In case the implant ruptures, severe contracture, or both are discovered, the revision surgery can be scheduled where old implants will be taken out and new and better, state-of-the-art implants will be inserted within the same operation and the patient will receive a new implant. We do not leave you to your own devices, either full of anxiety or guessing your health situation. You get both confirmation and a course of action that we are perfectly coordinated to carry out.
Frequently Asked Questions About Implant Problems
Most of the time, there is no sensation at all (silent rupture), but a few women have experienced a burning sensation, tingling, or have noticed the appearance of small, hard lumps (granulomas) where the gel has leaked.
According to the current guidelines, you should have an MRI or a high-quality ultrasound scan 5 to 6 years after the operation and then continue to do so every 2 to 3 years afterwards to check for silent ruptures.
It is not a condition that can cause death, but it can be a source of pain and, if neglected, the permanent distortion of the breast aesthetic can result, thus requiring surgery to cut the scar tissue.
The presence of an air bubble or a fluid pocket in the pocket right after surgery is, in most cases, the reason for this; it usually clears up on its own within a few weeks as the body takes in the air.
Although it is very unlikely, the compression applied in mammograms can theoretically rupture an implant that is old or weakened, which is why you must inform the technician that you have implants so that they use special “displacement” methods.
Hölmich, L. R., et al. (2005). The diagnosis of silicone breast-implant rupture: clinical findings compared with findings at magnetic resonance imaging. Annals of Plastic Surgery.
Bengtson, B. P., et al. (2007). Style 410 cohesive silicone breast implants: safety results at 3 years. Plastic and Reconstructive Surgery.
Maxwell, G. P., & Gabriel, A. (2014). Biofilms and breast implant contracture: Was the era of texture a mistake? Aesthetic Surgery Journal.
