Breast implant extrusion is one of the rarer and more serious complications a patient can experience after augmentation, and it’s understandable that even reading the term is alarming. It refers to a situation where the implant begins to push through and become visible or exposed at the skin surface – and it is always a surgical emergency, not something to watch and wait on.

The good news is that true extrusion is uncommon, and it almost always develops gradually, with recognizable warning signs beforehand. Knowing what those signs look like, and what causes them, means you can get help early – well before the situation becomes a true emergency.

What Is Breast Implant Extrusion?

Extrusion occurs when the tissue covering a breast implant thins, breaks down, and eventually opens, allowing part or all of the implant to become exposed through the skin. It’s the end stage of a process that usually starts with tissue compromise over the implant – most often at the incision site, at a pressure point, or over an area of chronically thin or damaged skin.

This is different from a simple wound separation, though the two can be related. In wound dehiscence, an incision reopens but the implant remains fully covered. In extrusion, tissue breakdown progresses to the point that the implant itself is partially or fully visible or exposed.

Extrusion is rare, but when it happens, it requires urgent surgical attention because an exposed implant is at very high risk of infection and further tissue loss.

What Causes Breast Implant Extrusion?

Extrusion doesn’t happen without a reason – it’s typically the result of one or more of the following:

Infection. Untreated or inadequately treated infection is one of the most common contributors. Infection weakens the tissue covering the implant and can cause progressive breakdown of the skin and underlying layers.

Capsular contracture with tissue thinning. In some cases of severe, longstanding capsular contracture, the tissue over the implant can become abnormally thin, especially if there have been previous surgeries in the same area.

Thin or compromised soft tissue coverage. Patients with very little natural breast tissue, thin skin, or a history of radiation to the chest (for example, prior breast cancer treatment) have less of a protective buffer over the implant, increasing risk if any wound problem develops.

Wound healing complications. Poor wound healing – from smoking, uncontrolled diabetes, certain medications, or nutritional deficiencies – increases the risk that an incision or pressure point won’t heal properly, setting the stage for extrusion if left unaddressed.

Trauma. A direct injury to the breast, particularly one that damages the skin overlying the implant, can create an opening that progresses toward extrusion if it doesn’t heal correctly.

Implant malposition or excessive pressure on one area of tissue. When an implant sits abnormally against a specific point of tissue for an extended period – often related to implant malposition – chronic pressure at that point can gradually thin the overlying tissue.

Repeated revision surgery in the same area. Each additional surgery through the same incision or tissue plane reduces the blood supply and resilience of that tissue, which is one reason we’re thoughtful about how many revisions we recommend and when.

Breast Implant Extrusion Symptoms and Warning Signs

Extrusion develops in stages, and catching it early dramatically simplifies treatment. Warning signs include:

• A red, thin, or shiny patch of skin over the implant that doesn’t resolve or gets progressively thinner
• A small area of skin breakdown, scab, or wound that isn’t healing over the implant
• Visible bluish or grayish discoloration through thinning skin, sometimes described as the implant “showing through”
• Clear or blood-tinged drainage from a small opening near the implant
• A palpable edge or ridge of the implant becoming more prominent under increasingly thin skin
• In advanced cases, direct visibility of the implant shell through an open wound

Any of these signs – even the earliest ones, like a small non-healing area of skin – should prompt an urgent call to your surgeon. This is not a “wait a week and see” situation.

Breast Implant Extrusion Treatment

Treatment depends on how far the process has progressed, but the priorities are always the same: control infection, protect remaining tissue, and address the implant.

Early-stage intervention. If caught at the stage of thinning or minor skin breakdown, aggressive wound care, antibiotics if infection is present, and close monitoring can sometimes prevent progression to full extrusion. This is the best-case scenario and underscores why early reporting matters so much.

Implant removal. Once true extrusion has occurred – meaning the implant is exposed – the standard treatment is prompt surgical removal of the implant. Attempting to leave an exposed implant in place carries a very high risk of serious infection.

Delayed reconstruction. In most cases, once the tissue has fully healed after removal – which may take weeks to months – a new implant can be placed in a subsequent procedure, sometimes using a different pocket, technique, or additional tissue support to reduce the risk of recurrence.

Treating the underlying cause. Whatever caused the tissue compromise in the first place – infection, thinning, malposition – needs to be addressed before considering re-implantation. Otherwise, the same problem is likely to recur.

We discuss all of this candidly with any patient managing this complication, including through our breast implant exchange evaluation process, because timing and sequencing matter as much as the individual steps.

BREAST AUGMENTATION GALLERY

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Can Breast Implant Extrusion Be Prevented?

Prevention starts well before any warning signs appear:

• Careful evaluation of tissue quality and thickness before augmentation, particularly for patients with very little natural breast tissue
• Meticulous surgical technique to avoid unnecessary tissue trauma and to select an implant size appropriate for the available soft tissue coverage
• Prompt treatment of any signs of infection or wound healing problems, rather than waiting to see if they resolve on their own
• Avoiding smoking, which significantly impairs wound healing and increases risk of nearly every surgical complication, including this one
• Following activity and incision care instructions closely during recovery
• Attending all follow-up appointments so any early tissue changes are caught while still easily treatable

At Partington Plastic Surgery, implant size and placement recommendations are always calibrated to your existing tissue quality and thickness – not just your desired look – specifically to minimize this kind of risk.

Frequently Asked Questions

Concerned About Your Recovery?

If you’re noticing any skin changes, non-healing areas, or unusual sensations around a breast implant, don’t wait for it to resolve on its own. Early evaluation is the single biggest factor in a good outcome.

Contact our practice for an urgent evaluation →

Learn more about our breast implant exchange process for patients who need implant removal, replacement, or revision.

References

1. U.S. Food & Drug Administration. “Risks and Complications of Breast Implants.” FDA.gov
2. American Society of Plastic Surgeons. “Breast Implant Complications.” PlasticSurgery.org
3. Handel N, Cordray T, Gutierrez J, Jensen JA. “A long-term study of outcomes, complications, and patient satisfaction with breast implants.” Plastic and Reconstructive Surgery. 2006;117(3):757-767. PubMed
4. Spear SL, Murphy DK. “Natrelle round silicone breast implants: Core Study results at 10 years.” Plastic and Reconstructive Surgery. 2014;133(6):1354-1361. PubMed

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