Ruptured silicone implants

Ruptured breast implants should be removed as soon as possible. Remember that silicone is relatively inert and shouldn't specifically harm you, but it should be removed or replaced sooner than later.

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Mommy,
This is a very complex situation that you present, requiring an extensive discussion with a board certified plastic surgeon and possibly a breast surgeon. There is no great urgency, but it sounds like your implants can and should be replaced. It is possible that if your implants are older model technology, they may not be ruptured, but instead may be "bleeding" silicone (a microscopic leaking through an intact shell). This bleeding silicone may be taken up by the lymph nodes. The removal of the nodes would have to be discussed with your treating surgeons, as everything we do in surgery and life, has consequences and you need to know what those are. Good luck!

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Dear Mommy of two, I have read all that is listed below and I agree wholeheartedly with the following:

1-There have been many studies that show that leaking silicone does not pose any risks to systemic disease or collagen vascular disorders.

2-The older implants had a thin shell that would leak or disintegrate quite often.

3- Usually, the silicone gel would be contained within the scar capsule.

4- Some of the silicone may leak into the nearby tissues and lymph nodes. Of note, and not mentioned previously, some silicone in the breast tissue may become inflamed and present as a mass or nodule in the breast. You cannot pass this off as nothing,because of the risk of a missed breast nodule of a dubious nature. Therefore you have to biopsy these nodules as they become apparent.Therefore it is essential to change ruptured or leaking silicone implants.

Finally, replacement can be performed at the same time and the newer cohesive gel implants should not have the same risks as previous generation implants.

Good Luck.

Robert Freund, MD, FACS

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It is certainly not an emergency, but ruptured implants should be replaced. I would not do aggressive surgery to remove all the leaking silicone, specially in your lymph node. Leaving a little silicone in your tissues is not going to hurt you.

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I am uncertain from our questions exactly what you are asking. I will try to separate the components of your questions and hopefully this will be helpful. First, should ruptured silicone implants be removed? Yes. The body forms a capsule which compartmentalizes the silicone implant, so that, even if ruptured, they are contained within this capsule. However, if they are ruptured, then they should be removed or replaced. In this situation, it is not an emergency, but can be scheduled electively -- there is no "rush" to replace them. The second part of your question asks about silicone in the lymph nodes. Do you have enlarged lymph nodes? If so, have you had a proper work-up including a physical exam, medical imaging and possibly a lymph node biopsy? If not, these are questions that you have to address with your surgeon and primary physician sooner rather than later.

David Shafer, MD
Shafer Plastic Surgery
Manhattan

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