One of the known complications of the use of saline breast augmentation is the lifelong potential of deflation of the implants. Often referred to as rupture or developing a hole in the implant, the term deflation is more appropriate as it occurs without warning as the implant just slowly deflates over hours or days. (and sometimes weeks and months) While this is not a rare occurrence, there is a fair amount of misinformation as to how and why saline breast implants deflate.

 
First and foremost, the actual occurrence of saline implant deflation is around 1% per year for the lifetime of the implants. This would mean that 1 in 10 saline breast implants will undergo deflation within 10 years after placement. That is not a rare risk and every patient who considers or has them should understand that it is not a question of whether saline breast implants will deflate, it is only a question of when. In my opinion, a 10 to 20 year lifespan would be considered good and the younger a patient is who gets them, the more likely they will need replace them. I think patients under the age of 50 should mentally factor in that they will probably require replacement surgery of one or both breast implants in their lifetime.

 
Secondly, saline breast implants fail due to fractures occurring in the plastic shell. This leads to a full-thickness hole which causes the leak. This development is a natural occurrence which will eventually occur due to the wrinkling of the implant shell (from the saline fill) that causes fatigue fractures at the microscopic level of the material. It is not a result of anything the patient usually has done and it is not their fault. It is an inevitable biomaterial development.

 
Thirdly, most saline breast deflations are relatively acute. Meaning the change in the outward appearance of the breast usually occurs fairly rapidly over hours or a day or two. While there are cases where a ’slow’ leak occurs over weeks to months (partial deflation), this is not that common. There may or may not be some pain associated with the deflation which is the result of the normal scar around the implant (capsule) shrinking onto itself (contracting) as it has lost its underlying support. Most certainly, all saline breast implant deflations result in very discernible external changes with a clearly smaller breast, bottoming out of the lower breast skin, and very significant asymmetry to the opposite side.

 
Saline breast augmentation is a very good procedure that works well. The patient must understand, however, that the saline breast implant has a limited llifespan and eventual replacement will be needed in many patients. The deflation of a saline breast implant is usually unexpected, appears rapidly for no reason, and constitutes a ‘cosmetic emergency’ to which patients appreciate a rapid replacement solution.

 
Dr. Barry Eppley
http://www.eppleyplasticsurgery.com
http://www.ologyspa.com
Clarian North Medical Center, Carmel, Indiana
Clarian West Medical Center, Avon, Indiana
Indianapolis