|
Implant Deflation and Rupture
Disruption of the Implant Shell
Saline and silicone gel implants both have a shell made of solid silicone. This shell is soft and pliable, but it may also tear. When a saline implant shell tears, it is called a deflation, because the enclosed saline leaks out and is absorbed by the body, resulting in marked shrinkage of the breast. When a silicone gel implant shell tears, it is called a rupture. The enclosed silicone gel might extrude to varying degrees, but the breast does not usually change in size.
Risk
The risk of saline implant deflation is about 1% per implant per year. Silicone gel implant rupture rate is about 4% during the first four years, which makes them roughly equivalent during that time frame. Rates thereafter have not yet been determined, but studies are underway.
Fill Volume
Saline deflation may be reduced by overfilling the implant to the manufacturer’s recommended specifications. Yes, you read that right: overfilling reduces deflation. This is because deflation results from repeated folding of the implant shell. Underfilled implants tend to fold more often. An implant shell that has folded hundreds or thousands of times may weaken and tear—not unlike a piece of paper which is folded multiple times along the same crease. There is no advantage in minimum fill volumes.
Overfilling does not apply to silicone gel breast implants, as they are always pre-filled to their optimal volume by the manufacturer.
Saline Implant Deflations
If your saline implant deflates, chances are that it will be obvious and almost immediate. When a deflation occurs, the breast typically shrinks over hours. One woman reported having symmetrical breasts when she got in the bathtub, but noticed obvious shrinkage by the time she got out. It is possible, although unlikely, to have a slow deflation (over weeks or months) or to have a partial deflation such that the breasts appear only slightly asymmetrical. In general, these are rare occurrances, and such asymmetries are more likely due to change in implant position, change in weight, or change in perception.
Silicone Implant Ruptures
If a silicone gel implant ruptures, the silicone gel may extrude and cause a capsular contracture which is usually the first and only sign of a rupture. However, not all ruptures lead to capsular contractures, which is why women with silicone gel implants are encouraged to consider an MRI scan every two years (following the third year after the implant was placed). Unfortunately, MRI scans are only about 90% accurate in identifying ruptures, so a negative scan does not necessarily mean your implant is intact; nor does a positive scan (one showing a rupture) necessarily mean that you truly have a rupture. For this reason, many women choose to forego MRI scans unless or until they notice problems.
Treatment of Deflations and Ruptures
Saline deflations require surgery for placement of a new implant. Silicone ruptures require replacement in addition to capsulectomy, which is surgical removal of the surrounding scar tissue.
If I Treat My Breasts Delicately, Can I Prevent Deflation or Rupture?
Intuitively, it makes sense that doing so might help prevent deflation or rupture, but it does not. You should treat your breasts the same as un-implanted breasts. Do not be guarded or concerned about your significant other handling your breasts. Also, mammograms do not cause deflation or rupture, so you should not defer annual mammography (recommended for all women over 40).
|
