Is it safe to fly in an airplane with a ruptured silicone breast implant, which ruptured 6 months ago?

From the Guidelines

Flying with a ruptured silicone implant that occurred 6 months ago is generally safe, but it is crucial to consult with your plastic surgeon before travel to assess the implant's condition and any potential risks associated with air travel 1. The cabin pressure changes during flight will not worsen the condition of an already ruptured implant. However, if you're experiencing symptoms like pain, inflammation, or changes in breast shape, you should seek medical attention before flying. According to the American College of Radiology, an MRI is recommended by the FDA to evaluate for rupture, but US can identify extracapsular silicone, which presents as a classic “snowstorm” pattern and may be useful if mammographic findings are equivocal or the patient cannot undergo mammography 1. Some key points to consider when flying with a ruptured silicone implant include:

• Silicone from a ruptured implant typically remains contained within the breast capsule (called an intracapsular rupture), though some silicone may leak into surrounding tissues (extracapsular rupture) 1.
• While modern silicone implants use cohesive gel that tends to stay together rather than spread widely, it's still recommended to have the ruptured implant removed and replaced when possible.
• During your flight, no special precautions are needed specifically for the implant, but if you experience increased discomfort, apply cold compresses and take over-the-counter pain relievers like ibuprofen (400-600mg every 6 hours as needed) if not contraindicated for you.
• Upon returning home, follow up with your surgeon to schedule removal and replacement of the implant if you haven't already done so, as the rate of implant ruptures increases with time, and most of them do not cause any clinical symptoms 1.

From the Research

Risks Associated with Flying with a Ruptured Silicone Implant

• There are no direct studies that address the specific risks of flying with a ruptured silicone implant.
• However, studies have shown that rupture rates of silicone breast implants are initially very low and begin to increase after 6-8 years of implantation 2.
• The majority of silicone implant ruptures are clinically undetectable, and symptomatic patients may present with capsular contracture, breast lumps, or changes in breast shape 2.
• Patients with ruptured implants have been studied closely, and the consensus of the literature states that there are no health risks associated with implant rupture 2.

Diagnosis of Silicone Implant Rupture

• Ultrasonography is an effective imaging modality for the diagnosis of silicone gel breast implant rupture, with a sensitivity of 74% and a specificity of 89% 3.
• Other imaging modalities, such as magnetic resonance imaging (MRI) and photon-counting CT, can also be used to diagnose silicone implant rupture 3, 4.

Stresses of Air Travel

• Air travel imposes stresses on passengers, including acceleration, vibration, noise, lowered barometric pressure, variations of temperature and humidity, and fatigue 5.
• Healthy passengers normally tolerate these stresses quite well, but passengers with pre-existing medical conditions and reduced physiological reserves may be at risk of becoming ill during or after the flight 5.
• Physicians should assess patients before air travel, particularly those with underlying pulmonary disease, to minimize potential harm 6.

Assessment for Air Travel

• Patients with pre-existing medical conditions, including those with ruptured silicone implants, should be assessed before air travel to determine their fitness for flight 6.
• The assessment should include a thorough medical history, physical examination, and evaluation of any underlying medical conditions 6.