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What percentage of breast implants rupture?

Breast implants are medical devices that are used in cosmetic and reconstructive surgeries to augment or reconstruct the breast. Like any medical device, breast implants do carry risks, including the possibility of rupture over time. In this article, we will look at the rupture rates for different types of breast implants to understand the percentage that can be expected to rupture.

Saline Breast Implants

Saline breast implants are filled with sterile saltwater. If a saline implant ruptures, the saltwater is harmlessly absorbed by the body. According to studies, saline breast implants have the following rupture rates:

  • 5-10% rupture rate at 3 years
  • 10-15% rupture rate at 5 years
  • 15-20% rupture rate at 10 years
  • 25-30% rupture rate at 15-20 years

As we can see, the rupture risk increases over time for saline breast implants. After 10 years, nearly 1 in 5 saline implants can be expected to rupture, and after 20 years, up to 30% may experience rupture.

Factors Affecting Saline Implant Rupture

Some factors have been found to increase the risk of saline implant rupture:

  • Underfilling or overfilling of the implant
  • Damage during surgery
  • Fold flaw in the implant shell
  • Excessive compression or trauma to the breast

Proper surgical technique, avoiding trauma, and selecting undamaged implants can help reduce saline implant rupture risk.

Silicone Breast Implants

Silicone breast implants have a silicone gel filling. Rupture of these implants may lead to silent rupture, where the gel leaks out slowly without noticeable changes to the breast. Here are the rupture rates for silicone breast implants:

  • 2.5-5.7% rupture rate at 3 years
  • 8.4-14.7% rupture rate at 5 years
  • 13.6-20.4% rupture rate at 10 years
  • 34.4% rupture rate at 13 years

Over 10 years, around 1 in 5 silicone gel implants will experience rupture. The risk increases to over 1 in 3 implants at 13 years post-surgery.

Factors Affecting Silicone Implant Rupture

Factors that increase silicone breast implant rupture include:

  • Damage during surgery
  • Breast trauma or compression
  • Mammography
  • Capsular contracture
  • Implant age

Avoiding damage during surgery and trauma after implantation may help reduce rupture rates.

Implant Generations and Rupture Rates

Advancements in breast implant technology have led to the development of newer “generations” of implants. Each generation has design changes aimed at decreasing rupture rates. Here we will look at rupture rates by implant generation:

1st Generation

The earliest silicone breast implants produced in the 1960s-70s. These 1st generation implants had a thick elastomer shell and silicone gel filling. Studies found rupture rates of up to 70% at 10-years due to flaws in the manufacturing and design of these early implants.

2nd Generation

2nd generation implants were introduced in the late 1970s with some improvements to the shell and gel. However, long-term studies still found high failure rates:

  • 26% rupture rate at 5 years
  • 51% rupture rate at 10 years
  • 69% rupture rate at 13 years

3rd Generation

3rd generation implants came out in the late 1980s and early 1990s with more substantial changes, including:

  • Thinner, low-bleed shell
  • More cohesive silicone gel
  • Textured surface

These changes led to improved rupture rates of:

  • 9.2% at 5 years
  • 14.7% at 10 years
  • 20.1% at 13 years

4th Generation

Introduced in 2005, 4th generation silicone implants have further improvements:

  • New proprietary gels with higher cohesion
  • Thicker and more durable shells
  • Adjustment options for fill volume

These 4th generation implants have rupture rates of:

  • 3.3% at 5 years
  • 7.7% at 10 years

This represents at least a 50% reduction in rupture rate compared to earlier generations at 5 and 10 years post-surgery.

5th Generation

The latest generation of silicone breast implants introduced within the last 5 years have even more advanced gels for natural movement and shells that resist rupture, tearing, and leaks. However, long-term rupture rate data is not yet available for these latest 5th generation implants.

Implant Placement and Rupture Rates

The placement of the breast implant can also impact rupture risk. Studies have found:

  • Subglandular placement (over the muscle) has higher rupture rates than submuscular placement (under the muscle).
  • Submuscular placement has about 50% lower rupture rates compared to subglandular.

The additional coverage of the implant provided by the chest muscle in submuscular placement protects the implant from compression and trauma, reducing risk of rupture.

Detecting Silicone Implant Ruptures

Due to the “silent rupture” of silicone gel implants where the gel leaks out slowly, regular screening is recommended to detect ruptures early. The following methods can be used to screen for implant rupture:

  • Physical exam – The doctor looks for visual signs of rupture during a breast exam
  • Imaging – MRI scans can detect ruptures and small leaks of silicone gel
  • Ultrasound – Can identify rupture in some cases but may miss small leaks

The FDA recommends women with silicone gel-filled implants get regular MRIs starting 3 years after surgery, then every 2 years to screen for silent ruptures.

Replacing Ruptured Breast Implants

If implant rupture is detected, it is recommended to have the implants replaced. For reconstruction patients, Insurance will often cover replacement of ruptured implants. For cosmetic augmentation, the patient will need to pay to have the ruptured implants removed and replaced.

Replacement can be done immediately or can be delayed until later. In some cases, women opt to have the ruptured implants removed but not replaced.

Conclusion

All types of breast implants have a risk of rupture over time. However, advances in modern implants have significantly lowered rupture rates compared to early implant designs. Silicone gel implants pose the highest risk of rupture, so regular screening MRIs are recommended to detect silent ruptures before they progress and lead to complications. With appropriate implant selection, surgical care, and monitoring, women can reduce their chances of experiencing a ruptured breast implant.