A recent story from the New York Daily News reports on a young woman who had a breast implant ‘fall out of her body’. While very unfortunate for this young lady, this very concern is one that prospective breast augmentation patients often ask if it can happen. Since the most common location for the incision for inserting breast implants is the inframammary fold area, it would seem logical that it could happen if the incision came apart.
But is that what actually happened in this unfortunate young lady’s breast implant? Not exactly. In reading her story what she had actually developed was a severe form of capsular contracture, a well known complication that can happen to breast implants. While described in the newspaper story as the body rejecting the implant, this is not accurate at all.
Capsular contracture is when the body surrounds the breast implant with too much scar. When a lot of scar forms around an implant it can contract and make the breast hard. This happens because the breast implant is round and when the surrounding scar tightens, like a drawstring on a pair of sweatpants, it makes the scar shrink around the implant.
While what causes capsular contracture around most breast implants is not well understood, it is usually mild when it does occur. It is historically more common when old-style silicone breast implants were placed above the chest muscle. But most breast implants today are placed below the chest muscle and this has dropped the occurrence of capsular contracture significantly.
But when capsular contracture does occur it usually displaces the breast implant higher, not lower…and particularly not through the insertion incision. How did that happen in this patient? Multiple surgeries and weakness in the incisional closure make it possible for the weight of the implant to push open the incision and cause the lower end of the implant to stick out through the incision. The implant can not fall out of the incision because the width of the breast implant is bigger than the length of the incision. But it does make for a good headline even if it is a bit misleading.
Is this ‘implant falling out of the breast’ something a woman should fear if she she gets breast implants? No. This is a rare phenomenon that requires an extraordinary set of circumstances to occur. As long as the breast implant is not too big and its size does not exceed the breast tissue needed to support it, this is not a problem that is going to occur.
Dr. Barry Eppley
Indianapolis, Indiana