Dr. Linder sees patients from all over the world, including Beverly Hills, Hollywood and Las Vegas, who will have ruptured implants. Implant simply do rupture over time, both silicone and saline. The rate of rupture varies. It is up to 5 to 7 percent over 10 years that patients with saline implants will have a ruptured implant. Textured implants have certainly been shown to rupture greatly more than smooth implants due to increased folding along the textured implants which causes creases which leads to deflation. We do not use textured implants just because of the increased rate or rupture as well as the sticking to tissue in an improper position, usually superiorly malpositioned.
Ruptured implants clinically can be determined with saline implants. However, with silicone implants the FDA requires MRI's be performed every two to three years in order to determine a ruptured implant. The linguini sign, which is seen on MRI's, is pathopneumonic for a ruptured silicone implant. When a patient decides to have silicone implants, she should understand that an MRI will be required every three years minimum in order to detect rupture, and a mammogram and ultrasound can be completely wrong and are not sensitive to rupture whatsoever with silicone implants. When a saline implant ruptures, it can occur with a slow leak. With a slow leak, patients may not notice a complete deflation over two to three months. Once the patient finds an obvious rupture in an implant, it should be corrected as soon as possible. The longer a woman waits with a ruptured implant, the greater the risk of severe encapsulation, scar tissue and complete collapse of the pocket. Whatever portion of the implant collapses, the body will constrict around the implant and form increased scar tissue. The greater the scar tissue, the greater the deformity of the breast will look as well as the more difficult it will be for the plastic surgeon to try and recreate a normal shape.
With silicone implants ruptures are "silent," meaning that they can be ruptured for many, many, many years and that is why MRI's should be performed every three years in order to detect a rupture as soon as possible. A ruptured silicone implant should be taken to surgery as soon as possible, as ruptured silicone implants will leak silicone and this can calcify and form hard scar tissue, silicone calcified granulomata as well as silicone can leak into different lymphatic structures, including the axillary lymph node, spleen and other lymphatic sources.
Repairing patients with ruptured implants usually requires explantation, open capsulotomy and capsulectomy, if there is enough tissue, releasing scar tissue and then replacing the implants as necessary.
Stuart Linder, M.D., F.A.C.S. is a Beverly Hills and Las Vegas Breast Revision Surgeon who enjoys performing breast augmentations, breast revisions, breast lifts, breast reductions and breast reconstructive surgery. He is a Diplomate of the American Board of Plastic Surgery and a Fellow of the American College of Surgeons and a Member of the American Society of Plastic Surgeons.
Stuart A. Linder, M.D., F.A.C.S. Las Vegas Breast Revision Specialist
9167 W Flamingo Rd, Suite # 110, Las Vegas, NV 89147
Phone: (702) 434-7205