All man-made products can age with time, and breast implants are no exception. In the 1970s and the 1980s, silicone implants were made of thin protective shells with liquid silicone gel inside. These implants were placed in an area just underneath the breast tissue (as opposed to under the pectoralis muscle) because patients recovered without much downtime and discomfort, and surgeons found that this approach was technically easier. As these silicone implants age, the shells can break down, releasing liquid silicone gel into the surrounding tissues.
This causes visible and palpable distortions around the breast tissue. In all women who undergo breast augmentation with silicone implants, the body forms a pocket around the implant called a capsule. This is a normal response by the body to the implants. As silicone implant shells begin to break down over time, the silicone content can still be largely contained in the capsule, separating the silicone from the surrounding breast tissue. However, the capsule can begin to harden and become thickened as a response to the direct contact with the silicone content of the implant.
If the capsule begins to break down as the result of the hardening and brittleness, the silicone content then can infiltrate the surrounding tissues. The good news is that there are options to exchange out ruptured silicone breast implants. Under general anesthesia, an incision can be made in an area under the fold of the breast, and the breast implant material and the capsule are removed together. The pocket is thoroughly cleaned out, and a new implant of the same or different size can be placed to improve the look and feel of the breasts.