Clinical Management After Rupture of Silicone Gel-Filled Breast Implants in a Surgically Treated Cohort: A...

Breast implant rupture is clinically significant complication that is often asymptomatic making diagnosis challenging. The primary objective of this study was to describe the clinical presentation, preoperative imaging findings, and operative findings in this surgically selected cohort. A secondary objective was to assess the apparent concordance of magnetic resonance imaging (MRI) and ultrasound findings with intraoperative rupture status in this surgically selected cohort. Additional exploratory analyses examined symptom categories, implant age, and implant placement in relation to operative and imaging findings.

This retrospective observational study evaluated a cohort of women with suspected or confirmed silicone breast implant rupture who underwent operative management at the Department of Plastic Surgery, Faculty of Medicine, Comenius University, University Hospital Bratislava, Ružinov, between 2020 and 2025. Because only patients who proceeded to surgery were included, the cohort represents a selected referral population rather than an unselected surveillance population.

The mean patient age was 50.6 years, with a mean implant age of 14.7 years. Within this surgically selected cohort, MRI demonstrated higher apparent sensitivity and positive predictive value than those of ultrasound; however, diagnostic performance varied across subgroups and the findings should be interpreted cautiously because of the small sample size and selection bias. In patients with local symptoms, the apparent diagnostic performance was lower, particularly for ultrasound.

Breast implant rupture showed heterogeneous clinical presentations in this retrospective cohort of surgically treated patients, ranging from asymptomatic, imaging-detected rupture to cases associated with local symptoms, capsular contracture, or systemic complaints. MRI showed a higher apparent concordance with intraoperative rupture status than ultrasound in this selected cohort; however, the findings are limited by selection and verification bias. Subgroup analyses were exploratory, and clinical management should remain individualized; prospective studies are needed to guide evidence-based imaging and treatment strategies.