Breast augmentation with silicone gel implants remains a very popular procedure, and implants continue to improve in quality and design. Surgical techniques are also getting better, and for these reasons, implants will last a very long time for most patients. In fact, all breast implants sold in the U.S. have a lifetime manufacturer’s replacement policy. But issues such as implant rupture are always a source of concern and a subject of contradictory information. That is why understanding silicone implant ruptures is essential. Here, I will set the record straight about what causes implant rupture, what the consequences are, and what to do about it when it happens.
What Is Breast Implant Rupture?
The first thing to know is that implant rupture is usually a silent event, so the patient doesn’t notice or feel anything different. “Rupture” isn’t really a good way to describe it; it’s more like a gradual breakdown of the outer silicone shell, eventually resulting in a small crack or tear. It’s rare that there is an accident or identifiable event that causes a rupture. And because the gel within the implant is a cohesive semisolid material somewhat like gelatin, it is almost always contained within the capsule or “pocket” that the body forms around the implant. (Any type of implant anywhere in the body will have a capsule form around it.) The term for this is “intracapsular rupture.” The gel in the implant is just another form of silicone polymer, one of many forms of silicone that are used in everything from kitchen tools to joint replacements.
What Causes Implants To Rupture?
You have probably heard that implants have to be replaced every 10 years or so. That is based on historical data from earlier generations of implants. One feature of these implants is that they were underfilled; that is, the amount of gel placed into the implant shell was a little less than the volume of the form used to make the shell. The thinking was that this would make the implants feel softer and more natural, but what happened instead was that it allowed the implant to fold and ripple, which contributed to “wear and tear” over time, allowing actual cracks to develop. Implants are now typically filled to the full volume, so they should hold up better. Other improvements include how the silicone itself is manufactured.
Capsular contracture can also contribute to implant rupture. This is where the capsule thickens and squeezes the implant, resulting in the breast feeling firm. It compresses the implant, causing folds to develop and eventually rupture. Fortunately, capsular contracture is becoming less common.
Can a Ruptured Implant Make You Sick?
The short answer is almost certainly no. We know this from several studies where women with ruptured implants were identified on routine screening with MRI studies, but some elected not to have their implants removed or replaced right away. Most of them eventually did have them replaced, but none developed systemic illness or autoantibodies over 3 years of follow-up (Hölmich et al., 2003; Hölmich et al., 2004; Jagasia et al., 2025). So if you have a ruptured implant, there is no urgency to have it replaced from a health point of view.
How To Know if You Have an Implant Rupture
When silicone implants were re-approved by the FDA in 2006, there was a recommendation that women have a screening MRI study every few years to monitor for rupture. Of course, very few did this because of expense and inconvenience, and why do it when everything feels fine? Now, many, if not most, plastic surgeons have the ability to evaluate implants with ultrasound in the convenience of their own office. I offer this to all of my implant patients at no charge.
Meet With Us Today To Learn More About Silicone Implant Ruptures
Understanding silicone implant ruptures is an important part of making informed decisions about breast augmentation. Contact us today to schedule an appointment.
References
Jagasia P, Timmerman R, Dolivo D, Allison S, Hong SJ, Galiano R, Kim JYS, Fracol M. Rupture of Breast Implants Does Not Cause Systemic or Local Immune Changes. Aesthet Surg J. 2025 Apr 16;45(5):463-469
Hölmich LR, Vejborg IM, Conrad C, Sletting S, Høier-Madsen M, Fryzek JP, McLaughlin JK, Kjøller K, Wiik A, Friis S. Untreated silicone breast implant rupture. Plast Reconstr Surg. 2004 Jul;114(1):204-14
Hölmich LR, Kjøller K, Fryzek JP, Høier-Madsen M, Vejborg I, Conrad C, Sletting S, McLaughlin JK, Breiting V, Friis S. Self-reported diseases and symptoms by rupture status among unselected Danish women with cosmetic silicone breast implants. Plast Reconstr Surg. 2003 Feb;111(2):723-32
