Since breast implants were first developed over 30 years ago, many women with implants have noticed strange sensations in their breasts when they fly in commercial airliners. The sensations can persist for a few hours to a day or two after they land. Many have postulated that the implants were at risk of exploding, but none of the many reports of exploding implants has ever been confirmed. Despite this, the myth is so persistent that it has been busted not once, but twice, on the show Mythbusters. Now a radiologist in Colorado has finally solved the mystery of the strange implant sensations associated with airplane travel. It turns out that the problem is not that the implant expands too much, but that it expands too little to keep up with the expansion of the normal tissue around it (our bodies expand when the air pressure around us decreases). This difference in expansion (the scientific term is compressibility) causes the creation of a potential space around the implant. Although initially a vacuum, it quickly fills with nitrogen gas coming out of solution in the surrounding tissues. It is exactly the same process that, when it happens in joints, causes the bends. The implant, which was tightly held by the surrounding tissue, is now able to slosh around in a pocket of nitrogen gas. In fact, sloshing is a common descriptor used by the women with implants who have these sensations.
What is the proof? It turns out that one Colorado woman complaining of these sensations called her doctor, who ordered both an ultrasound of her breasts and a CT scan of her chest. The latter was ordered because she was also having some shortness of breath. She had flown to Colorado from New York the day before and immediately driven to her home in the mountains (which is where she received her scans). Although she didn’t relate her symptoms to her recent trip, when the CT scan showed the (never before reported) finding of gas surrounding her implants, she mentioned her airplane trip to the radiologist, who immediately knew that they had the answer to a decades-old mystery. Once he saw the finding on CT, he was able to recall a mammogram from his files that showed the same thing. A look at his records showed that the mammogram in question was that of a flight attendant.
Why has no one seen (or at least published) this phenomenon before? It probably could only happen at altitude. The gas surrounding the implant is reabsorbed as the tissue pressures equalize. This process happens fastest by landing at sea level. By landing staying at high altitude after landing, the subjects in this paper maintained their gas collections long enough that they were imaged during their routine care.