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Breast Implants
How can you tell if your silicone implant ruptured?
Often you simply can't tell. Modern cohesive silicone gel implants frequently rupture silently: the gel holds together inside the scar capsule and there may be no symptoms at all. When signs do appear, they can include a change in breast shape or size, new firmness, swelling, lumps, or an asymmetry that wasn't there before. Because ruptures can be silent, screening matters. Current FDA guidance accepts either ultrasound or MRI, beginning five to six years after placement and repeating every two to three years afterward , a meaningful update from the era when MRI alone was the recommendation, since ultrasound is cheaper and easier to obtain. If imaging confirms a rupture, removal with or without replacement is generally recommended, though with cohesive gel this is rarely an emergency. If your breast has changed, or you are simply overdue for screening, see your plastic surgeon and get the imaging on the calendar.
Clinical Context
Ruptures come in two types. In an intracapsular rupture, the more common type, the shell breaks but the gel stays contained within the scar tissue capsule, which is why a physical exam or mammogram often misses it. In an extracapsular rupture, silicone spreads beyond the capsule and is more likely to cause a lump or visible shape change. MRI detects rupture most reliably; ultrasound is a more accessible, still acceptable alternative for routine screening.
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