Photograph of a woman wearing a bra pushing her breasts up

I Have a Ruptured Breast Implant. What should I Do?

Breast augmentation remains one of the most popular cosmetic procedures in the U.S.  Almost 300,000 women underwent this procedure in 2019.  Many women find their self-confidence soars after getting breast implants.  However, like almost every other medically implanted device, breast implants won’t last forever.  Saline-filled implants usually last about 13-14 years.  Silicone implants may last a bit longer, but they will also eventually leak.  Here are a few things to consider if one or both of your breast implants wear out.

Signs that a breast implant is leaking

Photo of a woman with a ruptured left saline breast implant
(Her left breast saline implant is ruptured)

If you have saline breast implants and one begins to leak, you’ll know it.  Typically one implant becomes soft, then the breast deflates.  This can happen overnight, or it can become noticeable over a week or so.  The affected breast loses all of the shape the implant had created.  The differences between the breasts become obvious.

That’s not usually the case with silicone implants.  Many women who have ruptured silicone implants don’t even know an implant is ruptured.  It is found incidentally during a routine mammogram.  They are surprised because they haven’t noticed anything different in their breasts.  This is called a “silent rupture“.  On the other hand, some women do notice a change in one or both breasts.  Maybe a breast has become firm, for instance.  Sometimes a nodule is felt where there hadn’t been one before.

If you have breast implants and experience any of these scenarios, you should visit with your primary care physician or a plastic surgeon.

Will insurance pay for surgery when a breast implant is ruptured?

Insurance companies might  pay for surgery when a breast implant leaks.  It depends on the type of implants you have, the reason you had the implants placed, and what types of problems you are experiencing.

Most of the time insurance will not pay for surgery if you had saline-filled implants placed for cosmetic reasons.  Insurance might pay to have ruptured silicone gel implants removed.  Often the surgery is a little more extensive if a ruptured silicone implant is present.  If the breast with the ruptured implant has become hard, you may require a capsulectomy to remove the implant, the silicone, and some of the scar tissue in the breast around the implant.  That type of surgery is often not required when a saline implant ruptures.

Breast implants are also used in breast reconstruction.  A woman who had one or both breasts removed to treat cancer may have breast implants placed to reconstruct the breast(s).  In that situation, insurance will usually cover the cost of the surgery.

If you are hoping to have insurance pay for surgery, your plastic surgeon will have to write to your insurance company to see if this is a ‘covered benefit’ of your insurance policy.  Your insurance either will or will not cover the costs of the surgery.  The plastic surgeon can check with them about this, but does not make the decisions for your insurance company.

Are any tests necessary when I have a ruptured breast implant?

For a woman who had breast implants placed for cosmetic reasons, the main test that is required is a mammogram.  That is going to be required for any woman who is over the age of 39, no matter what type of breast implant she has.  For someone with saline-filled implants, probably no other breast imaging is required.  With silicone implants, however, additional imaging may be required.  For instance, if one breast becomes firm and a mammogram does not show that an implant is ruptured, either an ultrasound or a breast MRI may be indicated.  Ultrasounds and MRI’s are the best tests to demonstrate whether silicone breast implants are intact or ruptured.

Visiting with a plastic surgeon

If you have an established relationship with a plastic surgeon, give that office a call.  The people there will direct you on how best to proceed.

If you don’t have an established relationship with a plastic surgeon and you are older than 39, your best option is probably to contact your primary care physician (PCP).  Your PCP may be able to direct you to a reputable plastic surgeon that she/he knows.  If you have silicone implants, it is likely that you will require either an ultrasound or an MRI of your breasts.  If you’ve already had this test done before you visit with a plastic surgeon, the surgeon can have a much more meaningful discussion with you during your first visit.  Your PCP can order that test and have the result sent to the plastic surgeon.  That way, by the time you visit with the surgeon, he/she will already know the details of whether one or both implants have leaked.

If you have saline-filled implants, you probably won’t require an ultrasound or MRI.  However, if you’re over 39, you will require a mammogram.  It’s best to have this done before you visit with a plastic surgeon.

It’s also very helpful to know the details about your breast implants.  Knowing which company made the implants is important.  Your rupture may be covered under a warranty.  If you know what company made your implants, it is possible that you are eligible for new implants without having to pay for them.

Also, it’s nice to know the volumes of your implants.  You might decide you want to have larger or smaller implants than you have now.  If you know the volume (not the cup size, but the volume) of your implants, you’ll be able to make more informed decisions as you visit with the surgeon.

When you had your breast surgery, you were likely given a card that has information about your implants.  If you can find that card, take it with you to your visit.  If you can’t find the card, there are a couple other options.  If you know the name of your surgeon, contact that office to see if they have the information.  If the surgeon is no longer practicing, you might contact the facility in which your surgery was done.  They may be able to provide a copy of the operative note.  The surgeon dictated a note after your surgery, and in that note he probably listed the details about your breast implants.

What are my options when I have a ruptured breast implant?

There may be several options available, depending on your findings, your desires, and your overall health.

  • Some women decide to just have the implants removed and not have new implants placed.  That may work well if you have a moderate amount of breast tissue covering your implants.  Sometimes, though, the result does not look terrific.
  • Most women I see want to have new implants placed.  They have built a wardrobe and lifestyle around the way they have looked with their implants and they want to maintain that.  Women who had saline implants often change to silicone implants at this time.
  • Another option might be to remove the implants and do a breast lift.  That works well for someone who has a moderate amount of droopy-appearing breast tissue.
  • Fat grafting is an option too.  We can do liposuction of a few areas and inject that fat into the breast.  Sometimes this is done instead of placing new implants.  Fat grafting does not add enough volume to make you look like you used to when you had implants.  However, it can add a modest degree of fullness to the breasts, and that’s all some women want.
  • Some women choose the “deluxe combo”.  They have their implants removed, new implants placed, and do breast lifts as well.

Of course, you really need to visit with a plastic surgeon to learn about your options.  Each woman is unique and has her own physical attributes, health history, and desires.  Two women who have similar physical findings and histories may choose very different options from each other.

If you have questions about ruptured saline of silicone gel breast implants, contact us!  There are many good options.  The internet will tell you the options, but you need to visit with a plastic surgeon to determine what might work best for you.



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