Breast Implant Rupture Rates are Decreasing As Devices Improve

Breast implants have been around since 1962 when they were developed by 2 Houston plastic surgeons.  The design and manufacture have come a long way.  After a number of design flaws with the earlier devices, implant manufacturers improved the silicone gel devices.  At one point however the shells of the implants were not very durable and were subject to phenomena such as " silicone gel bleed" where the outer shell appeared to be intact but was permeable to the silicone which would leak out in small amounts. This also contributed to a high rate of capsular contracture. By 1990, some reports had estimates of rupture rates of 50% after 10 years of implantation.  The moratorium on silicone gel implants that occurred in 1992 had a significant impact on plastic surgery practices, however it did allow the manufacturers to go back to the drawing board and design safer more durable breast implants.  Since then, the design and manufacturing processes have gotten even better with newer implants now having a more cohesive material within the outer shell.  These implants have a lower rate of rupture because they are less susceptible to folds in the implant shell which occur with movement.  These folds can rub against each other and over time developed what is called "crease fold failure" which is one of the most common findings of a ruptured implant.  The other areas of weakness of the implant shell include the outer patch (where the gel is placed during production) that is bonded to the outer shell which may be susceptible to breakdown.It is also felt that some ruptures can be attributed to damage done during the insertion of the implant.  More recent use of insertion funnels are likely to help reduce this risk and Dr. Glenn Lyle utilizes the Keller Funnell in all of his breast implant insertion cases.

Right now, the rupture rate of implants varies by manufacture and even the style of implant but generally is less than 1% per year meaning that in 10 years less than 10% of women have developed a breast implant leak.  Leaking implants are not always apparent on physical examination and are often found with monitoring with ultrasound, CAT scan or MRI. MRI is the most sensitive but also the most expensive.  The FDA recently changed their recommendation.  They used to recommend an MRI at 3 years and then every 2 years after placement.  Very few women actually did this.  Now they recommend an MRI between year 5 and 6.  Many surgeons recommend monitoring with ultrasound which is more readily available and less expensive.

Dr. Lyle does perform hand-held ultrasound evaluation of breast implants however a formal radiographic evaluation by radiologist is recommended if any abnormalities are noted.

This 42-year-old woman had silicone gel breast implants placed 14 years ago.  She had a CAT scan to investigate another unrelated issue and was found to have bilateral breast implant rupture.  This was considered a "silent rupture" as she had no symptoms.  At the time of surgery, Dr. Lyle found completely disrupted breast implants, but they were contained within the implant capsule (intracapsular rupture). The implant material was removed safely within the capsule.  The patient had had a prior mastopexy, so this was revised, and smaller implants were placed.  The patient was very pleased with the improvement and had peace of mind knowing that her breast implant material had been removed.