Ruptured Implant Microscopic Leakage
Silicone gel implants can rupture either through a direct tear within the shell of the implant or microscopic leakage can occur over years through the shell itself without an obvious tear or loss of integrity of the shell. The video here shows a patient recently operated on with ruptured silicone implant calcification material surrounding the bag and with calcification within the capsule. On examination of the implant, notice there is a microscopic porous leakage of silicone particulate through the implant shell and that the actual silicone is quite sticky externally and it stretches out as small fibrous silicone and silicone beading. This patient’s implants were placed approximately 12 years ago. The implants have no obvious tear within the shell of the implant, but there is the microscopic silicone leak. By placing the implant directly on a piece of paper and lifting it after 30 seconds, a film of silicone can be identifiable on the paper. This shows that there is microscopic leakage of silicone material through the older silicone shell of the implant. This may not be as prevalent with the newer cohesive gel implants with thicker silicone shells, but over time I believe that most implants will have microscopic porous leakage through the shell and that implants should therefore be replaced either way, whether found to be ruptured on MRI or just due to the microscopic leakage over time. Ten to 15 years postoperatively, the patient should have silicone implants replaced due to this phenomenon.