The two main categories of breast implant rupture are intracapsular implant rupture and extracapsular implant rupture. Treatment of a ruptured silicone implant also involves removal of the ruptured implant and possible replacement with a new implant. We only differentiate between intracapsular and extracapsular rupture when referring to silicone implants. Mammography effectively detects free silicone in breast tissue with extracapsular rupture (25% of ruptures according to some studies); however, it cannot detect rupture within the implant capsule. Intracapsular rupture: This is the more common form of rupture accounting for 80-90% of ruptured implants. Intracapsular rupture takes place when some or all of the gel leakages past the silicone covering of the implant but stays within the coarse capture that has actually formed around it. Breast implant removal is a relatively straightforward. But saline implant ruptures may cause a reduction in breast size and tissue. Now for the good news: ruptured implants can be fixed. Silicone implant rupture can lead to either intracapsular or extracapsular involvement and has many more potential complications. Breast implant ruptures are rare and often have no symptoms. Silicone implant ruptures cause the gel to escape outside the capsule and alter breast shape. Ultrasound lacks sufficient sensitivity to show intracapsular ruptures, as the silicone is relatively hypoechoic and produces significant artifact on imaging. In the majority of implant ruptures, the gel is contained by the fibrous capsule the body forms around the implant, so-called “intracapsular ruptures”. The leakage of the silicone doesn't extend beyond the fibrous capsule and most often is unrecognised because of a lack of symptoms or physical changes in … After capsulotomy or capsulectomy the new implant may be placed. Even with silicone, an implant rupture is not an emergency situation. Dr. Saline implant rupture results in the extravasation of a simple normotonic saline solution that is harmless and will be reabsorbed by the body over time. Both types of implant ruptures cause knots or lumps, pain, tenderness, or a constant burning sensation in breasts. A bulging of the implant contour can suggest an intracapsular rupture. If the implant rupture is intracapsular then the procedure will involve a total capsulectomy and implant removal on the ruptured side. Classic findings on ultrasonography include the “snowstorm” sign of extracapsular rupture and the “stepladder” sign of intracapsular rupture. Generally the treatment method is to remove the ruptured implant or implants with a basic breast implant removal procedure. Most experts agree that it is important to remove a ruptured implant (i.e., explanted) shortly after diagnosis has been confirmed. An intracapsular silicone implant rupture is very difficult to see on mammography. Any silicone that may have leaked into surrounding areas can be extracted as well. The longer the silicone is allowed to remain in the body, the more time it has to migrate to other parts of your body, like the lymph glands. By comparison, an extracapsular tear is when the totally free silicone gel escapes through the capsule and right into the bust tissue. There is not immediate danger but without treatment, the silicone can harden and cause problems in the future. Treatment. MRI Findings: Iintracapsular rupture just means that there is a gel bleed / rupture within the capsule. A full course of antituberculous therapy [15,16] is essential before implants are replaced, requiring an average time of almost 1 year [15].Rupture of an implant is a common complication, and its incidence varies from 0.3% to 77% [17][18][19], but autoinflation of the breast secondary to these ruptures is extremely uncommon. When the gel spreads outside the fibrous capsule, it can migrate to the axillae, the back, arms, and even groin. You should have the implant removed with complete capsulectomy and replacement by your plastic surgeon. In some cases, the patient may choose to have new breast implants inserted.
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