Asymptomatic breast implant rupture detected in pregnancy: a case report and a management pathway

Breast implant rupture during pregnancy is rarely reported, and physiologic breast changes may obscure clinical detection. Management should prioritize maternal-fetal safety with rupture-related concerns. We report a gravida 3 woman with a 7-year-old textured silicone implant placed subpectorally in whom left intracapsular rupture was incidentally suspected during a breast ultrasound performed alongside routine antenatal assessment at 32 + 5 weeks' gestation. She remained asymptomatic, with no palpable abnormalities, inflammatory changes, or systemic signs. After multidisciplinary counseling, she was managed expectantly with scheduled clinical reviews and defined return precautions. Magnetic resonance imaging (MRI) was deferred during pregnancy because results were unlikely to change antepartum management. Postpartum MRI confirmed left implant rupture. Elective surgery and implant exchange seven months postpartum was uncomplicated. This case supports ultrasound-led, safety-netted observation until postpartum, and reinforces routine surveillance and preconception implant checks for women planning pregnancy.