A ruptured silicone breast implant is difficult to diagnose. It typically is not something you or your surgeon can feel on physical exam. The implants also generally look the same size as well.  The only accurate way to diagnose a ruptured silicone implant is by way of an MRI.  Regular mammograms and ultrasounds are not sensitive enough to detect a ruptured silicone breast implant. If you have any symptoms such as pain/burning sensation and you have MRI evidence of a ruptured breast implant, than you should have the implant replaced.  It is very unlikely for a cohesive silicone breast implant to rupture, but if you feel or see anything unusual with your implants, consult a board certified plastic surgeon for a thorough evaluation.