Letters Breast implants

Rupture of breast implant shell must be differentiated from gel bleed

BMJ 2012; 344 doi: http://dx.doi.org/10.1136/bmj.e2574 (Published 01 May 2012) Cite this as: BMJ 2012;344:e2574
  1. Catherine Boffa, SpR general surgery1,
  2. Ramsey I Cutress, consultant breast surgeon1,
  3. Caroline M Rubin, consultant radiologist1,
  4. Nigel Horlock, consultant plastic surgeon2,
  5. Gavin T Royle, consultant breast surgeon1
  1. 1Southampton General Hospital, Southampton SO16 6YD, UK
  2. 2Salisbury District Hospital, Salisbury SP2 8BJ, UK
  1. catherine.boffa{at}nhs.net

Confusion has been caused by differences in definition of leakage of silicone from breast implants.1 The Medicines and Healthcare Products Regulatory Agency website (www.mhra.gov.uk) usefully differentiates between rupture of the shell of the implant and gel bleed—a common occurrence.

Radiological reports may include the terms intracapsular and extracapsular rupture. In these reports capsule refers to the false capsule around the implant and not the shell of the implant.

True rupture of the implant shell is often accompanied by clinical “collapse” of the augmented breast and usually requires revision, whereas there may be no clinical change with gel bleed (or leach), and further treatment is not usually necessary.

The term “rupture” in relation to a breast implant might cause unnecessary anxiety for the patient when the findings actually result from a gel bleed.

We believe that radiological reports should use the term “consistent with gel bleed” where appropriate. This would be clearer and would reduce confusion, psychological upset, time, and money.


Cite this as: BMJ 2012;344:e2574


  • Competing interests: None declared.