Prospective Longitudinal Cohort Study of Implant Age, Pocket Plane, Incision, Surface Texture, and Volume as Predictors of Breast Implant Rupture

Inclusion Criteria: * Female sex and age 18 years or older. * Aesthetic breast augmentation with permanent silicone implants. * Known implantation date or sufficiently precise implantation year, pocket plane, incision route, surface texture, and implant volume. * Both implants or the analyzed implant documented as intact at baseline by the study imaging algorithm. * Ability to complete annual surveillance for up to five years. * Written informed consent. Exclusion Criteria: * Reconstructive implantation after mastectomy, congenital deformity, or major trauma. * Tissue expander or nonpermanent device. * Confirmed rupture at cohort entry for the implant under analysis. * PIP implant or another recalled device if the final protocol elects to exclude it from etiologic modeling. * Missing core implant characteristics or implantation date. * Planned immediate explantation or exchange at enrollment for a reason unrelated to surveillance.