Disclaimer: The following is not intended to be medical advice. Please consult with your doctor before making any medical decisions.
Each year, up to 365,000 women in the United States choose cosmetic breast augmentation, and more than 100,000 undergo breast reconstruction. While breast implants are FDA-approved medical devices, they are not without potential risks, and changes can sometimes develop months or even years after surgery.
Many women know to watch for obvious concerns, such as pain, swelling, or visible changes in breast shape. But signs of breast implant problems are not always easy to spot. Some can be subtle, gradual, or mistaken for normal changes in the body.
The FDA’s updated recommendations state that women with silicone gel-filled breast implants should have periodic imaging to screen for implant rupture, whether their implants were placed for cosmetic augmentation or breast reconstruction. These screenings are intended to evaluate implant integrity and do not replace other imaging that may be recommended based on your personal medical history, symptoms, or routine breast cancer screening needs.
Even if you do not have symptoms, the FDA recommends having your first ultrasound or MRI 5 to 6 years after your initial implant surgery, followed by repeat imaging every 2 to 3 years. If you develop symptoms at any time, or if ultrasound results are unclear, an MRI may be recommended for further evaluation.
Staying proactive about your breast health is one of the best ways to feel informed and empowered. By understanding the common signs of breast implant problems, you can better recognize when something may need attention and take the next step with confidence.
Breast implants can shift from their original position over time. In some cases, this change may be easy to see. In others, it may happen slowly and become noticeable only when you compare your current appearance to older photos.
Signs of implant displacement or shifting may include:
Because these shifts can develop gradually, they may be easy to overlook at first. If you notice a visible change in your implant position, it is important to contact your plastic surgeon for an evaluation.
Another sign of a potential problem is that your implants have changed shape. Some changes that can happen include wrinkling, flattening, bulging, rippling, or an uneven contour. One breast may also appear larger or smaller than the other.
According to the FDA, changes in breast size, implant shape, uneven appearance, hard lumps, pain, tenderness, tingling, swelling, numbness, burning, or changes in sensation may be associated with silicone gel-filled implant rupture.
A change in shape does not always mean that an implant has ruptured. However, it is still worth getting checked. A healthcare provider can help determine whether the change is related to your implant, breast tissue, scar tissue, or another cause.
Capsular contracture is one of the most common complications of breast implant surgery, whether implants are placed for cosmetic augmentation or breast reconstruction. According to the American Society of Plastic Surgeons, about 1 in 6 breast augmentation patients will experience some degree of capsular contracture.
Capsular contracture happens when the scar tissue that forms around your implant becomes thick, tight and hard. However, not every case will have obvious symptoms.
Capsular contracture is commonly described in four grades:
Grades I and II are usually considered normal. Grades III and IV frequently require corrective surgery.
About 75% of capsular contractures cases occur within the first two years after breast implant surgery. However, capsular contracture can also develop later. If hardening develops years after surgery, it is important to be evaluated, as your provider may also want to check for possible implant rupture.
Whether your implants were placed for cosmetic augmentation or reconstruction, it is important to understand how rupture may appear with different implant types. Saline and silicone implants can look and feel different when they rupture because they are filled with different materials.
You'll notice a saline rupture very quickly, as it is immediate and very noticeable. Saline is saltwater, and as it is harmlessly absorbed by the body, the implant will deflate. Your breast skin may feel saggy or loose, and you'll notice significant asymmetry when compared to your other breast.
Silicone ruptures are also known as "silent ruptures." This is because you may not notice an obvious change in appearance or feel.
Silicone gel is thick and tends to hold its shape, which means a rupture may go unnoticed for some time. Some women do not realize a silicone implant has ruptured until it is found on imaging.
Ultrasound is a useful screening option for evaluating silicone implant integrity, especially for women who do not have symptoms. If symptoms are present or ultrasound results are unclear, an MRI may be recommended for further evaluation.
New or persistent breast symptoms should always be discussed with your healthcare provider. This includes:
These symptoms may be related to an implant issue, but they can also have other causes. Possible causes may include scar tissue, infection, inflammation, trauma, changes in breast tissue, or other biological and lifestyle factors.
Because these symptoms are not specific to one condition, it is important not to guess at the cause. Your doctor or plastic surgeon can help determine what is happening and whether imaging or additional evaluation is needed.
Lumps, rippling, wrinkling, or changes near the underarm area may be related to your implants, but they should always be evaluated.
A breast ultrasound can look beyond the surface of the breast and help assess breast tissue, lymph nodes, and, when included, the implant shell. Ultrasound may also help identify imaging signs that can be associated with implant rupture or leakage, such as a collapsed or folded shell, free silicone, or other irregularities.
It is important to remember that not every breast or underarm change is caused by an implant. Some changes may involve the surrounding breast tissue or lymph nodes. That is why any new lump, texture change, or underarm concern should be brought to the attention of a healthcare provider.
Breast implant illness, often called BII, is a term some people use to describe a wide range of symptoms that may develop after getting breast implants.
According to the FDA, “breast implant illness” refers to a variety of systemic symptoms that some women report after receiving implants. These symptoms may include:
The FDA states that BII is not currently recognized as a formal medical diagnosis. At this time, there is no specific diagnostic test or official criteria used to screen for breast implant illness.
However, if you are experiencing ongoing symptoms that concern you, it is important to speak with your healthcare provider. They can help evaluate your symptoms, rule out other possible causes, and discuss next steps.
Periodic imaging is recommended for women with silicone gel-filled breast implants, whether the implants were placed for cosmetic augmentation or reconstruction.
The FDA recommends that women with silicone gel-filled implants have their first ultrasound or MRI screening 5 to 6 years after surgery. After that, screenings are recommended every 2 to 3 years.
These screenings are designed to evaluate the integrity of the implant and check for possible rupture. They are not a replacement for routine breast cancer screening.
Your screening needs may vary based on your age, symptoms, implant type, medical history, and your provider’s recommendations. You should always follow the guidance of your doctor when it comes to breast cancer screening, implant monitoring, and any new symptoms.
In addition to recommended imaging, it is helpful to stay familiar with the signs and symptoms of breast cancer and to perform regular breast self-exams at home.
If you have breast implants from cosmetic augmentation or reconstructive surgery, a breast ultrasound can help evaluate your breast tissue. When included as part of your visit, an implant integrity scan can also help assess the condition of your implants and look for signs that may be associated with rupture or leakage.
HerScan offers quick, convenient breast ultrasound exams designed to support early detection and proactive breast health. For women with implants, the same visit may also include an implant integrity scan to check for concerns such as a folded implant shell, free silicone, or other irregularities.
Taking a proactive approach to your breast health can help you feel more informed, confident, and in control of your care.