Breast Implant Rupture

Excerpt

Breast augmentation is a surgical procedure where fat transfer or breast implants (saline or silicone) are used within the native breast to increase size and projection. The implants are placed in a retroglandular or retropectoral position. Breast augmentation is performed for various reasons, including cosmetic augmentation, congenital malformations, or reconstruction after mastectomy. Approximately 3.5 million people in the United States have breast implants, making it one of the most commonly performed cosmetic surgical procedures. One possible complication of this procedure is implant rupture, which can occur in different ways.

There are many different varieties of saline and silicone implants, and any can potentially degrade, leading to rupture. When evaluating a potential implant rupture, important determinations to make include the makeup of the implant (saline implant or silicone implant), and the length of time the implant has been in place.

When an implant is placed, the body creates a scar around the implant, a fibrous capsule. This is a normal reaction to the foreign implant. An implant rupture contained within the fibrous capsule is referred to as an intracapsular rupture, while the extravasation of silicone outside of the fibrous capsule is called an extracapsular rupture. Saline implant rupture results in the extravasation of a simple isotonic saline solution that is harmless and will be reabsorbed by the body over time. Silicone implant rupture, however, can lead to further complications, though no actual health risks have been discovered in studies performed . An extracapsular rupture results in silicone gel extravasating into the surrounding tissues, often in an infiltrative pattern that can lead to significant local tissue reaction and scar formation. One important point is that there cannot be an extracapsular rupture without an intracapsular rupture; in other words, if the implant contents have escaped through the fibrous capsule, they are by definition present in the intracapsular space as well.

There is a distinction between older iterations of silicone prostheses and more cohesive, new-generation silicone implants. Apart from some exceptional circumstances, cohesive silicone will not spread to surrounding tissue; however, the silicone present in older generations of implants can be subject to wide dissemination, and in rare cases, has migrated as far as the inguinal area. [3]