Brrrrng. Brrrng. (phone rings.)
Patient XX: “I think my saline implant is leaking.”
Dr. G: “Tell me, what do you see?”
We then will get into a big discussion about the past few weeks. Do you see a difference in size? Did you have any trauma? (An injury, hit to the chest, recent mammogram, etc). Do you see an increase in the wrinkling? Loss of upper pole (ie cleavage) fullness?
Breast implants can leak. They are man-made objects and like all things eventually they can fail. So how do you know if your saline implant is leaking?
- Decrease in size. This one seems obvious, but saline implants are like sophisticated water balloons. When you poke a hole in a balloon, the water leaks out. If you think it is leaking, wait for a a few days- the water usually continues to leak out and the size difference will increase. Look at your other breast (the nonleaking one) to judge how much smaller it is. See how you fill out your bras.
- Increase in wrinkling. This is not a reliable indicator. More visible wrinkles and rippling is the most common reason patients call to say their implant is leaking. The increase in wrinkling could be due to a leak, but commonly is due to the skin thinning. When the skin is thinner, it can’t exert the same pressure on the implant. This allows the underlying implant to wrinkle more. Also when the skin is thinner you can see the underlying implant more- Imagine you are lying on a bed and instead of a thick down comforter you have a thin sheet covering you instead. You see more. The natural tendency over time is for the implant to thin the overlying tissue cover.
- Loss of fullness in the cleavage area. This also is not necessarily an implant leak. As an implant leaks and loses volume you would see less fullness in the upper breast, but another common reason for the implant to not be full in the cleavage area is settling of the implant. When your skin thins and stretches it allows the implant to settle down. See my blog on down and out.
The best way to figure it out is to go see your doctor. Mammograms are not reliable to tell you if it is leaking. A common reason for a saline implant to leak is fold failure- a small hole in the periphery of the implant. Trauma doesn’t usually cause the leak by itself- there has to be a weakness or hole present. I once had a patient who had been a horrible car accident and had a welt across her chest from her seatbelt. Her skin was not okay, but her implant was fine. Breast implants are generally quite durable. But at some point they can fail. And if you are within 10 years, you are likely still under warranty. The fix is an easy one usually- just a simple implant exchange. And unlike the first surgery (for most of you with implants under the muscle), not painful.