Detecting A Rupture
A saline implant rupture often requires no imaging to detect. A simple clinical evaluation demonstrating volume loss is sufficient. If mammography imaging is obtained, then the implant will often demonstrate a wrinkled appearance.
An intracapsular silicone implant rupture is very difficult to see on mammography. Ultrasound lacks sufficient sensitivity to show intracapsular ruptures. MRI is the most sensitive at detecting silicone implant rupture. Extracapsular rupture can often be seen with mammography and ultrasound, showing the silicone in the surrounding tissues or even axillary lymph nodes.
Common Signs of Implant Rupture
- Pertinent physical examination findings include:
- Breast shape and symmetry
- New breast masses
- Associated lymph node pain
- The texture of the breast implant in question versus the contralateral breast implant
- Skin changes in the affected breast versus the contralateral breast
- Nipple discharge
Can A New Implant Be Put in Immediately to Replace a Ruptured Implant?
The empty shell of a ruptured saline implant should be removed. A ruptured silicone implant should be removed because of the possible interaction with surrounding tissue and possible spread to local lymph nodes. Asymptomatic patients may be reluctant to undergo this procedure, but overall long-term safety is a priority. If an intracapsular rupture occurs, then a capsulectomy can be performed. If all silicone has been cleaned the surgeon may not remove the fibrous capsule. If there is a doubt about silicone persistence, the surgeon may attempt to remove the entire fibrous capsule that has been infiltrated by silicone. If the rupture is extracapsular, then it is possible that the patient will need several surgeries to retrieve all the silicone gel, with a delayed replacement of the implant to restore normal breast contour.
Consulting with A Plastic Surgeon
The first step to scheduling a consultation would be doing thorough research. There are many ways to find a plastic surgeon. Arguably the best way would be to receive a referral from another physician, such as primary care, dermatologist, or OB-GYN. These providers often see multiple patients with good results and can attest to those by referring their own patients somewhere. Friends are a secondarily good referral source, especially if they are patients themselves. When it comes to advertising, the most essential consideration is the plastic surgeon’s education, board certification ONLY by the American Board of Plastic Surgery, and before/after gallery. If those components match your desired outcome, then they would be a good source of information to seek in consultation. You will often come across taglines such as “no downtime surgery” or “no anesthesia required”. If it seems too good to be true, it probably is. There are no shortcuts to SAFE plastic surgery.
The next step would be contacting the office of a board-certified plastic surgeon to find a time to meet them. First impressions last a lifetime, so pay attention when speaking to the receptionist upon calling. Should you decide to have surgery, this is the team you will be dealing with multiple times per month for at least a year. The administrative team is a direct reflection of the surgeon’s ways of working. Another thing to clarify would be a potential timeline for surgery. This is sometimes best done before reaching out to qualified providers because they are booked one to six months out, on average. Knowing well enough in advance will give you adequate time to interview surgeons, get any preoperative lab work done, and feel confident moving forward with your scheduled procedure.