Saline Breast Implants are not filled to a “pounds per square inch (PSI)” like a football. They are filled to a specified volume based on the size and width of the breast implant shell, and do not have a propensity to “pop” like a balloon.
Saline Breast Implants have about a 1% per year deflation rate. Usually only one side will deflate at a time and the symptoms can be sudden or gradual depending on the area of leakage.
- A saline breast implant is similar to a water balloon without the inner pressure filling pressure (PSI), therefore a leak in the upper part of the implant may only empty a small amount with saline pooling at the lower half of the implant, therefore there may not be a complete loss of volume and this can be gradual. A mid to lower breast implant rupture may have a complete deflation.
The saline in the breast implant is sterile and will likely be reabsorbed by the body. Unlike their silicone counter parts which when they rupture it can lead to scarring and capsular contracture.
The symptoms of a saline breast implant rupture include:
- loss of volume in the breast (sudden or gradual) depending on the location of leak
- pain secondary to possible tissue adhesion around the inflation valve
- anxiety of not knowing the risks and solution to the problem.
Causes of rupture are usually not apparent but may include:
- Under-filling: just like in football, under-filling can lead to rippling in the breast implant, which can weaken the implant leading to early deflation. Overfilling to about 20% of the listed volume can help to eliminate these troublesome ripples.
- Wear and tear: pregnancy and weight fluctuation can lead to excess tension on the breast implant, which can weaken the implant shell.
- Rippling and scarring: capsular contracture can weaken the implant shell and make it more prone to weakening and rupture.
- Biopsies: in advertent puncture via instrumentation of the breast, either with a percutaneous needle biopsy or any open procedure around the breast.
Is this an emergency?
No, this is not an emergency, though it is a natural source of anxiety for patients when it happens. Typically a call to your plastic surgeon is warranted and an evaluation in the office will help to put your mind at ease.
- The area of leakage cannot be “patched” and then re-inflated like a tire.
It is important to have your breast implant information stored for reference because a secondary surgery will likely be needed and implant volume is an important piece of information when deciding on implant replacement volume. Typically an increase in 50 to 100 cc is commonly needed, though the option exists to remove the implants and not replace, or replace them with another style of implants and possibly perform a breast lift. Commonly, women are choosing silicone breast implants after having saline breast implants previously. Patient satisfaction is high and the feel is more natural.
Recovery after any secondary or revision type breast surgery is typically easier than the primary procedure. There is very limited down-time and resuming cardio activities is about 2 weeks. The implant pocket can be utilized after any scarring is removed, though implant pocket change may always be warranted if necessary. Soft tissue stretch and incisions are usually not an issue in implant replacement. New incisions could be made if a primary trans-axillary or trans-umbilical (TUBA) approach was performed.
Options for Treating a Deflated Breast Implant
- Remove the Deflated Breast Implant and Opposite side Breast Implant, replace/not replace. Decision for saline or silicone, volume and shape choice.
- Plane change, with either transposition under the muscle or sometimes over the muscle
- Remove and replace with a combination breast lift with breast implants
- Remove and not replace, but perform a breast lift with an auto-augmentation.
The first step in your revision breast surgery for a deflated saline breast implant is to consult with Dr. Trussler in his Austin Texas plastic surgery office to discuss your options.