In many cases, the ruptures of the mammary prosthesis occur without any apparent symptom and precisely because of this that it’s advisable to do a check or review every year.
If the prosthesis is less than ten years old and a rupture is suspected, a mammary ultrasound should be performed. It’s a low cost test, which is performed very quickly and is not aggressive at all. If this test doesn’t show any rupture, no further test is needed, but if the ultrasound leaves doubts an MRI should be performed to confirm or rule out any options. When ten years have passed since the placement of the prosthesis and the ultrasound offers results with suspected rupture, it’s not necessary to perform more tests because, due to its natural course -it has a fixed duration- it’s very likely that it will be. Of course, an MRI can be used to confirm this result.
Ruptures are very easy to detect when the breast implant if filled with saline serum. When they break or leak the liquid is absorbed by the body, reducing breast size in days or hours. In contrast, leaks in silicone-gel filled prostheses are asymptomatic and can go unnoticed to the patient but this situation has no immediate risk to the patient’s health. Sometimes, they can be detected by means of routine breast examinations such as mammograms, scans, breast ultrasound, magnetic resonance, among others, even though there’s no suspicion of rupture.
Accidents that could cause rupture
In general, in addition to the periodic checks of the prosthesis, it’s necessary to go to the doctor to verify their status if one of following cases happen:
- Cut or puncture wounds on the breast.
- If the breast has suffered severe trauma including injuries.
- If the result of the trauma has produced costal fractures or pressures that may have damaged the prosthesis.
- If there are significant changes in the size, consistency and location of the breast.
In all these cases, even if the breast volume has not decreased, it is advisable to go to the surgeon’s office to perform a check and rule out damages.
Although it’s necessary for women who have already had surgery and those who plan to have it to be fully aware that no breast implant lasts forever and that is why it’s very important to have regular checkups, the reality is that, to date, surgeons say that only a small percentage of patients perform these controls and make it a habit.
The patient should be very clear on how long a breast implant can last or after how much time it should be considered old and fragile, because implants, like any material over time, suffer an intense wear, nothing lasts forever. Many times when there is a traumatism in the first years in which the prosthesis is worn it doesn’t affect anything, but if the prosthesis is worn out, a rupture may occur.
The old mammary implants were made with non-cohesive gel and the cover was much less consistent and could be maintained, in optimal conditions, between ten and fifteen years.
The latest generation prostheses are made with a very cohesive gel and with many layers, which achieve less wear and are less fragile over time. The cohesiveness of the gel makes it much more difficult to leak. The more cohesiveness of the gel and more consistency in the layers of the wrap, the more safety and a wider lifespan.
Symptoms of a rupture
These are the main symptoms of a rupture:
- Pain, burning, tingling or stinging in the breast.
- Bumps or lumps around the breast or armpit.
- Inflammation and numbness of the breast.
- Change in size or shape of the breast.
The symptoms appear when the rupture is extracapsular, which means that the covering of the implant has been damaged and that the liquid has leaked out of the capsule that contains it. The capsule is the wrapping of connective tissue that creates the body itself inside the chest and that covers the implant as a reaction to it to isolate it.
How to detect a rupture when there are no symptoms
If there are no symptoms, the diagnosis can only be made by analyzing the clinical data and the radiological tests -ecography or magnetic resonance-, so it’s essential to follow the periodic examinations indicated by the surgeon, and not to go only when there are problems or discomforts. It should be noted that if the rupture is intracapsular, the capsule prevents the deformation of the implant, so normally there are no signs or symptoms.
It is important to say and stress that it’s not enough to do the medical checks and mammograms with the gynecologist, the plastic surgeon is the specialist in these topics and will know best any kind of issues you may have. It is also true that a mammography is not an adequate test to verify the state of the prosthesis, and after surgery, it’s advisable to perform the first magnetic resonance within a maximum of three years and repeat every two years.
Surgeons qualify resonance as enough confirmation, but in the first instance, an ultrasound is always recommended. An MRI could be an expensive test to do, so when an ultrasound is done, should be by an experienced radiologist with mammary prosthesis analysis background. It’s not easy to diagnose ruptures of mammary prostheses with only one ultrasound, since the radiological signs can be doubtful with the possibility of false positives, when an erroneous rupture is diagnosed, and false negatives, where there is a rupture but it goes unnoticed. If you want to go with a safe MRI, BonoMedico could offer very interesting discounts.
In general, unless advised otherwise or an issue comes up, these are the optimal periodic checks that patients should do:
- An ultrasound one year after surgery.
- An ultrasound every two years.
- After 10 years, the ultrasounds can be done annually.
- If the ultrasound leaves doubts about the state of the implant, the resonance must be performed and, if it is positive, the mammary prosthesis should be changed.