Leak or rupture of the implant may occur. When these problems occur with the hydrogel implant, two types of symptoms will become obvious. If the leak is very small in volume, the breast will gradually become smaller without any pain. If the leak is large in volume or if rupture of the implant occurs, the breast will become swollen, with or without pain and redness of the breast skin.
When a saline implant is used, leaks or ruptures of the implant will cause decreased volume of the breast. Patients who have saline breast implants should be informed that they must have a leaking implant replaced with a new implant within several days after noticing a volume change of their breasts. This is to prevent a change in the breast volume.
Otherwise, the capsule may shrink and replacement surgery will become difficult. If the patient does not want to have new implants and just wants to remove the ruptured saline implant, she can have surgery any time after noticing the problem.
When a rupture or leak of silicone implants takes place, the patient does not notice the problem in most cases. Therefore, patients with silicone implants should be advised to examine their breast implants together with the breast tissue once every year following the surgery.
Rupture or leak of the silicone implant may be caused by closed capsulotomy, mammography, or by accident. Also aging or weakness of the outer shell of the implant may cause the problem [29
When the rupture or leak of the silicone implant occurs, it will often occur only inside the capsule. In some cases, however, it may spread to the surrounding tissue through the capsule. The leaked silicone may cause cyst formation, inflammation, pain of the shoulder or upper arm, firmness of the skin, erythema, and/or edema [30
Recently, cohesive silicone gel implants have been made available. However, the grade of the cohesive quality, and it is not clear that the cohesive silicone will never leak out from the outer shell in the future. Even when the cohesive silicone implant is used, patients should be advised to have the implant and surrounding breast tissue examined every year.