2. DEFLATION or RUPTURE When silicone gel-filled implants rupture, some women may notice decreased breast size, hard knots, uneven appearance of the breasts, pain or tenderness, tingling, swelling, numbness, burning, or changes in sensation. Other women may unknowingly experience a rupture without any symptoms (i.e., “silent rupture”). Magnetic resonance imaging (MRI) with equipment specifically designed for imaging the breast may be used for evaluating patients with suspected rupture or leakage of their silicone gel-filled implant. Silicone gel may escape from the fibrotic capsule around the implant, may migrate away from the breast, and may cause lumps called granulomas to form in the breast, chest wall, armpit, arm, or abdomen. Plastic surgeons usually recommend removal of the implant if it has ruptured, even if the silicone is still enclosed within the scar tissue capsule, because the silicone gel may eventually leak into surrounding tissues. When saline-filled breast implants deflate, the saline solution leaks either through an unsealed or damaged valve or through a break in the implant shell. Implant deflation can occur immediately or progressively over a period of days, months, or years and is noticed by loss of size or shape of the implant. Additional surgery is needed to remove deflated implants. For silicone gel and saline-filled implants, some causes of rupture or deflation include: damage by surgical instruments during surgery overfilling or underfilling of saline (only) implant capsular contracture manually squeezing the breast to break the hard capsule trauma, injury, or intense physical manipulation excessive compression during mammographic imaging placement through the belly button normal aging of the implant unknown/unexplained reasons
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