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PS for Breasts Says if Cohesive Silicone Ruptures He Does Not Believe in Switching Them Out? Is This Normal?

I am trying to decide between silicone and saline. I have a good amount of breast tissue, a 32C. My PS that I am thinking about using told me, " Although the FDA recommends that you change a gel implant in the event of a tear, most plastic surgeons including myself, feel a ruptured implant does not need to be changes." Does this sound accurate?

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16 Doctor Answers | Asked by karen1978

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Replace silicone implants if ruptured

This may be a bit of a long-winded explanation, but I believe it requires some explanation. Although in general, the FDA recommendations should always be followed, it becomes more difficult with diagnosed ruptured breast implants with the new cohesive gel implants. The reason for this is that the implants today rupture at a very low rate, and the detection of a ruptured implant can be quite difficult. When a patient comes to the office with an MRI that shows a ruptured breast implant,... more

Rupture

The real problem is that in some patients the MRI is far too sensitive and the so called ruptures are actually just shell folding within the capsule and not really a rupture

Silicone leakage

While the FDA recommends replacement, replacing a leaking silicone gel implant is a decision that each plastic surgeon and patient should assess individually. Certainly if there is deformity or hardening, this decision easier to make. The dilemma is with "silent" rupture when detection is incidental and there are no symptoms or deformities. Often there is no immediate danger to the patient and these conditions can remain stable and asymptomatic for a long time. It is hard to recommend that... more

Robin T.W. Yuan, MD

4 reviews

Beverly Hills Plastic Surgeon

Implant failure and replacement

While I have not formally surveyed my colleagues, most, if not all, that I know would recommend replacing a failed implant. It will be more difficult to detect failure in the new form stable implants with MRI, but not impossible. We used a MRI which accurately diagnosed failure of one of these implants in a patient that I saw and treated. It is irresponsible to not replace a failed implant, especially given the controversy that silicone implants have had in the past. I believe that they are... more

Cohesive Gel implants ??

Could it be that you misunderstood your Plastic Surgeon ? The FDA states that you have to replace a ruptured implant . The FDA has on their website several pages dealing specifically about breast implants and you can read about their recommendations. Having said that nowadays with the high cohesive and form stable implants it is sometimes very difficult to figure out(even with an extensive examination and MRI) if an implant is broken. The gel stays contained in the shell and... more

Ruptured Implants Should Be Replaced?

Conventional wisdom is to replace implants in the event of rupture. Determining whether or not the form stable implants are ruptured may be difficult. Partial tears will be extremely difficult to detect. Many of these new form stable implants may well stay in for much longer periods of time for the reasons stated above.

To replace or not

The question you bring up raises a good point. If you opt for saline implants, then you don't need to decide whether or not to replace a broken implant. As far as a broken gel implant is concerned, I would definitely replace one that is broken. And remember, the manufacturer will provide a replacement for life free of charge.

Cohesive gel implant issues?

In my opinioin if an implants ruptures it should be exchanged out even if it is a cohesive gel implant that will probably maintain its shape.

Steven Wallach, MD

12 reviews

Manhattan Plastic Surgeon

No rush to replace ruptured cohesive implant

As you can see from the previous replies, part of the problem is that when a silicone gel implant develops an opening in the shell (rupture isn't really the right word), there is no change in the appearance of the breast so no real way to even know. One study screened a large population of women with implants with MRI's, and identified a number of cases of "rupture." About half of the women opted to have them replaced, and the other half were brought back about 2 years later and there were... more

Treatment of Ruptured Breast Implant

There are two things to consider regarding your question about whether to replace a "ruptured" cohesive silicone breast implant. First is how do you know that it is ruptured. It used to be that an MRI could detect a rupture as the gel would seep out of the shell and the shell could be seen on an MRI within the gel. With the newer cohesive gel implants there is a real question as to how to tell if they are ruptured since the gel stays cohesive and the shell should not migrate.... more

Implant Rupture

Even with highly cohesive implants, it is recommended to replace any ruptured implant. Over time, gel can migrate past the capsule and cause lumpy areas of silicone in your tissue if the rupture is ignored. This can take many years or can occur more quickly, impossible to tell. So, if there is an rupture, replace the implant.

Replacing ruptured silicone implants is the standard of care

While it is reported to be about 4.2 % for newer gel implant to fail, I have been using them for years and have placed hundreds of such implant and have only seen one fail. This was easily removed and replaced with little or no difficulty and with out any problems. When this implant failed it lost some of its shape and so there for the patient wanted to have it replaced. Regardless of how the breast looks, a broken implant should be removed and replace. Unquestionably silicone gel... more

Ruptured silicone implants should be removed

The accepted guidelines and protocol for the ruptured silicone implants is removal. Please make sure your surgeon is board certified plastic surgeon.

Kamran Khoobehi, MD

28 reviews

New Orleans Plastic Surgeon

Replace or Not Replace A Ruptured Silicone Breast Implant

It is fair to say that when you have a ruptured silicone breast implant using today's newer implant designs, you certainly have time to think about it. Unlike saline, silicone implants do not suffer from catastrophic failure. (deflation) Since there is another bag of scar around the implant known as the capsule, any silicone material can not go anywhere as it remains contained within the capsule and does not cause you any harm. Some may argue that if it feels and looks good then there is no... more

Ruptured Implant

Anytime you have a ruptured implant ( silicone or saline) you should plan to take the implant out. You may elect to replace the implant or not. Saline implants will deflate and the breast will decrease in size. Silicone implant rupture can be more difficult to determine. A ruptured silicone implant may cause pain, firmness or distortion of the breast. MRI is the best test to determine silicone implant rupture. In either case you should consult your... more

Plastic surgeons believe ruptured implants should be replaced

We hope you have misunderstood, for it is hard for us believe a board certified surgeon would ignore FDA guidelines concerning any medication or medical device. A ruptured or torn implant needs to be replaced period. Hope this is a surgeon you are just 'thinking' about.