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My Mastectomy Reconstruction Silicone Implant is Ruptured. Can Explant Enbloc and Saline Replacement Be Done at Same Time?

asked 1 year ago by sandy05 in Huntsville, AL
Latest answer by David L. Abramson, MD
Question viewed 397 times
Tags: saline implants, explant, rupture

I had bilateral mastectomy and silicone implant reconstruction in 2006. One of the implants has ruptured. Is explant with enbloc reccommended? Can a saline implant be put in during the same surgery? Can you explain the process for my situation?

14 answers to My Mastectomy Reconstruction Silicone Implant is Ruptured. Can Explant Enbloc and Saline Replacement Be Done at Same Time?

+1

Breast reconstruction

Yes capsulectomy and replacement with a new implant can be performed at a single surgical setting.
David L. Abramson, MD

New York Plastic Surgeon
+1

Removing a ruptured silicone implant

The treatment of choice for any ruptured silicone implant is to dissect around the outside of the capsule or scar tissue first.  That way the silicone gel can be removed "enbloc" inside of the capsule with less spillage.  With ruptured silicone implants the gel remains confined within the capsule usually.  Choice of reconstruction needs to be discussed with your plastic surgeon. If silicone was a good idea the first time it probably is still a good idea. more
Randy Proffitt, MD

Mobile Plastic Surgeon
+1

Replace Ruptured Implant

You should be able to have the ruptured silicone implant removed and a new implant replaced at the same time. Discuss with your surgeon if  any attention should be placed on the opposite breast
Leo Keegan, MD

Manhattan Plastic Surgeon
+1

Ruptured Silicone implant breast reconstruction may best be replaced with your own tissue flap

Typically an en bloc resection is performed with an intact breast. In a reconstructed breast, the amount of tissue which can be resected prior to compromising the wound becomes a critical factor. Alhough I understand your desire to have saline implants, it may be time to consider an autogenous tissue reconstruction.
Otto Joseph Placik, MD

Chicago Plastic Surgeon
+1

You can do both operations at once

You will most likely need a capsulectomy (or removal of the scar tissue around your implant) - this can be done at the same time as your implant removal and placement of a new implant.  You can use either the new silicone implants or saline at the time of your operation.  Good luck!
Bivik Rajnikant Shah, MD

Columbus Plastic Surgeon
+1

Replacement of Ruptured Silicone Implant Reconstruction

It is common place to replace the implant after en bloc removal of the ruptured silicone implant.    Prior to choosing a saline implant, take time to research the risk to benefit ratio of a saline versus silicone augmentation after mastectomy.    The newer silicone implant has a softer, more natural feel compared to saline implants.   Although a saline implant after mastectomy will give you the look and feel of a natural breast, a silicone gel implant will give... more
Paul S. Gill, MD

Houston Plastic Surgeon
+1

Remove implant and replace in one operation for reconstruction

Most of the time the procedure would be exactly as you describe, en bloc removal and a new implant at the same time. However, there are a number of considerations; for example, was there a capsular contracture? Also, will there be enough tissue for good coverage after en bloc removal? This would be especially important since saline implants are more prone to rippling and may not look as natural. In either case it might make sense to use an alloderm graft to add coverage and support, and... more
Richard Baxter, MD

Seattle Plastic Surgeon
+1

Can a leaking Breast Reconstruction implant be replaced with anothe at Same Time?

Regarding: "My Mastectomy Reconstruction Silicone Implant is Ruptured. Can Explant Enbloc and Saline Replacement Be Done at Same Time?  I had bilateral mastectomy and silicone implant reconstruction in 2006. One of the implants has ruptured. Is explant with enbloc reccommended? Can a saline implant be put in during the same surgery? Can you explain the process for my situation?" With exception of infection, I cannot think of a reason why you leaking silicone implant... more
Peter A. Aldea, MD

Memphis Plastic Surgeon
+1

Removal and Replacement- Usually a Single Procedure

In most situations, it is possible to remove ruptured implants and replace them with new implants at the same surgery. Certain circumstances, like the presence of infection, would preclude the placement of new implants. If you want to avoid implants, you could consider replacing your implants with your own tissue (for example with a DIEP flaps).
David Greenspun, MD, MSc

New York Plastic Surgeon

www.davidgreenspunmd.com

+1

Implant rupture

If your implant ruptured, you certainly can have it replaced in the same setting so that your reconstruction is not ruined.
Steven Wallach, MD

Manhattan Plastic Surgeon
+1

Breast reconstruction

There are two types of implant failure in silicone implants. The rupture and leaking silicone can be still contained within the capsule. In such cases a total capsulectomy (enblock) with the implant can be done thus no contamination of surrounding tissue. The other type of silicone implant failure is where the capsule is also ruptured or broken then the silicone is in the surrounding tissue. Again a total capsulectomy with the ruptured implant can be done, also as much of the free... more
Samir Shureih, MD

Baltimore Plastic Surgeon
+1

Implant Exchange

You will most likely require an implant exchange procedure.  you can also explore silicone gel implants as an alternative to saline.   please visit with a board certified plastic surgeon to learn more about your options.
C. Bob Basu, MD

Houston Plastic Surgeon

www.basuplasticsurgery.com

+1

My Mastectomy Reconstruction Silicone Implant is Ruptured. Can Explant Enbloc and Saline Replacement Be Done at Same Time?

Yes it is possible. But without an in person examination I could NEVER take it upon myself to try to explain the particulars of your personal case. Seek in person evaluations from boarded surgeons. From MIAMI Dr. Darryl J. Blinski
Darryl J. Blinski, MD

Miami Plastic Surgeon
+1

Implant exchange after breast reconstruction

Yes it is possible to have the ruptured silicone implant removed and a new saline implant placed during the same surgery. Your surgeon will likely try to remove the capsule around the ruptured implant intact to minimize the change that the leaked silicone will spill out.  This is not always possible and if some does leak out of the capsule it can be washed out during the surgery. Sincerely, Martin Jugenburg, MD
Martin Jugenburg, MD

Toronto Plastic Surgeon

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