Breast implant ruptures are unlikely, but it’s best to monitor them
Q. I have breast implants that are silicone. I am concerned about ruptures and other problems with them. What would you recommend me to do as far as making sure that the implants are not ruptured, and are there any recommendations for monitoring?
A. Approximately 4 million women in the U.S. and 10–15 million worldwide have breast implants, most commonly filled with silicone gel and, less often, saline. Breast implants remain the preferred method for augmentation and post-mastectomy reconstruction. Although extensive scientific evidence supports their safety, public concerns have persisted — leading to a moratorium on silicone implants in 1992. After thorough research found no link between implants and systemic disease, the FDA lifted the ban in 2006, approving a new generation of safer, more cohesive silicone implants.
These modern implants are less likely to leak or migrate if ruptured, and the FDA now recommends routine imaging every two to three years starting five to six years after implantation to monitor for silent ruptures. All implants, regardless of fill type, have a silicone elastomer shell that may weaken over time due to constant movement, folding and pressure. Ruptures in saline implants are usually obvious, as the implant deflates and the saline is absorbed. Silicone implant ruptures may be intracapsular (contained) or extracapsular (leaking into surrounding tissue), often without noticeable symptoms.
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Self-monitoring, regular physical exams and imaging are critical. While mammography is standard for breast cancer detection, MRI is the most accurate for detecting silicone implant ruptures, though ultrasound is often used first due to cost and accessibility. Ultrasound is highly effective but does not replace mammography for cancer screening.
Modern implants are highly durable — more than 90% remain intact at 10 years — but they are not lifetime devices. By staying informed and adhering to screening guidelines, women with implants can maintain their health and peace of mind. Ruptures are not emergencies but should prompt consultation with a board-certified plastic surgeon to consider implant removal or replacement.
Dr. Carlos Wolf is a partner in Miami Plastic Surgery and is board certified. Email questions to him at Cwolf@miamiplasticsurgery.com
This story was originally published March 26, 2025 at 5:50 PM.