Can Silicone Leak into Breast Milk After Breast Augmentation? — The Reality of South Korea's First Case Reported in 2017

There is exactly one case officially reported in South Korea by the Ministry of Food and Drug Safety (MFDS) in January 2017 regarding silicone being detected in breast milk after breast implant surgery.

This occurred when an implant ruptured and the leaking silicone gel entered the milk ducts and mixed into the breast milk.

It was the first official case reported in Korea and represents an extremely rare phenomenon with virtually no other reports in medical literature.

As long as the implant remains intact, it does not come into direct contact with the mammary gland tissue,

meaning it does not affect breastfeeding.

I previously wrote a column for The Hankyoreh in 2019 regarding this case.

Here, I summarize what was written back then and what has changed since.

What Happened in 2017

According to the MFDS announcement on January 12, 2017,

a mother who gave birth in 2016 noticed a viscous liquid mixing with her breast milk during nursing and sought care at a university hospital in Seoul.

An MRI confirmed an implant rupture and that silicone had leaked through the mammary ducts.

This marked the first time that the presence of silicone in breast milk was officially documented as an adverse event in South Korea.

The infant who ingested the silicone exhibited no health abnormalities,

and the mother underwent implant removal surgery.

Following this report, the MFDS announced plans to conduct a comprehensive safety re-evaluation of 7 types of implants manufactured by 5 companies used domestically by March 2017.

According to data released at the time, approximately 3,600 breast implant adverse events were reported over the preceding four years,

with ruptures accounting for 66% of those cases.

Why This Occurrence Is Extremely Rare

Implants are placed, at a minimum, underneath the mammary gland tissue.

When placed in a dual-plane (submuscular) position, the muscle sits between the mammary gland and the implant.

Even with subfascial placement, the implant remains isolated from the mammary gland by the fascia.

Most importantly, an inserted implant is isolated and contained by a capsule—a fibrous tissue layer naturally formed by our own body.

For silicone from an implant to mix into breast milk, the implant shell must rupture,

the surrounding capsule must be compromised,

and a pathway must exist for the leaked silicone to migrate into the mammary duct tissue.

In my 2019 column, I wrote:

"Due to the anatomical nature of breast augmentation and silicone implants, it is exceptionally difficult for silicone to leak through the nipple, and virtually no cases have been documented in academic literature."

This remains true today.

As long as there is no rupture and the implant is in its normal anatomical position, it does not affect breastfeeding.

Key Takeaways from 2019 That Remain Valid Today

Fifth-generation silicone implants, often referred to as "gummy bear" implants, are designed with high cohesiveness so that the contents do not easily leak out even if the outer shell tears.

Consequently, even if a rupture occurs, the shape and texture often remain unchanged, leaving patients unaware of the damage.

What the 2017 case highlights is not that "silicone routinely leaks into breast milk," but rather that "ruptures can progress asymptomatically, making periodic check-ups essential."

The U.S. FDA recommends that patients with silicone implants undergo their first imaging screening 5 to 6 years after surgery,

followed by follow-ups every 2 to 3 years thereafter.

Like any surgery, breast implant procedures carry potential risks such as inflammation, infection, and capsular contracture, where the capsule thickens.

These issues are rare and manageable when properly understood and prepared for.

One should always exercise caution against advertisements claiming that breasts can easily be enlarged using unverified procedures or unauthorized substances.

Things to Check If You Plan to Breastfeed

Incision placement. A periareolar incision traverses the mammary tissue, so the risk of damaging the milk ducts and nipple sensation should be addressed during your consultation. Inframammary fold (underbust) and transaxillary (armpit) incisions do not pass through mammary tissue.

Implant placement. Understand whether the placement is dual-plane or subfascial, and clarify what tissue layers lie between the mammary glands and the implant.

Breast implants are medical devices subject to track-and-trace monitoring, meaning records exist detailing which specific product was implanted in each patient.

If a substantial amount of time has elapsed since your surgery, having an ultrasound screening prior to pregnancy and nursing is recommended to rule out rupture.

<Frequently Asked Questions>

Q. Can I not breastfeed if I have breast implants?

A. That is not true. Because implants lie beneath the mammary tissue, they do not interfere with nursing. However, periareolar incisions cut through glandular tissue and nerves, so you must discuss your breastfeeding plans during your consultation.

Q. Is it harmful to the baby if silicone mixes into breast milk?

A. In the 2017 case report, the infant showed no health complications. However, because data is exceedingly limited, you should discontinue breastfeeding and seek immediate medical evaluation if you notice an abnormal fluid mixing with breast milk.

Q. Can I tell on my own if an implant ruptures?

A. Modern implants feature high cohesiveness, so they do not readily spill their contents upon rupture, preserving both shape and feel. Therefore, ruptures are frequently difficult to detect based on symptoms alone. They are confirmed through ultrasound or MRI.

Q. Should I postpone surgery because of this reported case?

A. There is only a single officially documented case in South Korea, which remains globally unique. It is not a reason to defer surgery, but rather a compelling reason to carefully evaluate incision location, implant pocket placement, and a long-term screening plan.