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Saline implants may develop a pinhole leak and lose their volume over time. The patient will notice increasing asymmetry that usually develops over a period of days to weeks. Occasionally, the implant only partially deflates, and other times it goes flat instantly. A small silicone gel implant leak may go undetected for years. Any change in look or feel should prompt an evaluation.

Treatment of Deflation, Rupture, or Leak

There is no “fix flat” injection technique like there is for automobile tires; thus, an operation is needed. Rarely, a patient may elect to have the opposite side (saline implants) deflated for symmetry to test how it would be without implants or because revision surgery is not possible for some months. It is best to have surgery as soon as practical; more capsule and muscle adjustments are needed if delayed for several weeks or months.

The simplest procedure is to replace the one deflated implant. Usually, a minimal capsule release is also performed to maintain symmetry with the other side. If saline implants are ten years old or older, it might be best to replace both implants during the same surgery. Of course, any trip to the operating room offers a chance to revisit breast size, shape, and asymmetry or to accomplish any non-breast procedure desired under the same anesthetic.

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