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25 Year Old Silicone Implants w/ Capsular Contracture - Replace?

asked 1 year ago by Los Angeles3773 in Los Angeles, CA
Latest answer by Rod J. Rohrich, MD
Question viewed 755 times
Tags: silicone implant, capsular contracture, replacement

I have 25 year old silicone implants over the muscle with Baker Grade II capsular contracture. I have just had a mammogram which showed no obvious leaks. I am torn trying to decide whether to replace them as they still look pretty good but just feel pretty hard. I would be devastated to go thru all that and come out looking worse or the cc recurs at a worse Grade than before.

17 answers to 25 Year Old Silicone Implants w/ Capsular Contracture - Replace?

+2

Aging Implants and Capsular Contracture

As implants get older, especially silicone, it has been shown scientifically that implants get hard with time and if they begin getting significantly hard and painful they need to be replaced. That usually happens within 10-15 years. I would definitely seek out your Board Certified Plastic Surgeon to see if you need implant replacement which will include capsulectomy as well if you have silicone implants.
Rod J. Rohrich, MD

Dallas Plastic Surgeon
+2

Silicone implant contracture

Whenever you consider "redoing" an operation, I think of what would  or could be done differently this time.  First of all, the fact that your implants are 25 years old means that your new implants will be of better quality. The new generation implants of today are far superior to those manufactured 25 years ago. Also, you could choose to place your implants under the nuscle- a position that decreases their palpability and reduces the likelihood of capsular contracture... more
Cynthia L. Mizgala, MD

Metairie Plastic Surgeon
+2

Replace 25 year old implants

If you were my patient, I would suggest removal and replacement of the implants and the capsule as well-unless your implants are above the muscle (I would imagine they most likely are) I would place new implants submuscularly. My concern with doing nothing is continued capsular contracture that really distorts the shape of your breast and results in you needing a mastopexy as well to correct the deformity. Good luck!
Thomas B. Lintner, MD

Atlanta Plastic Surgeon
+2

Capsular contracture

If you have a tight capsuel and the implants are over the muscle, you should probably have them exchanged and placed under the muscel.
Steven Wallach, MD

Manhattan Plastic Surgeon
+2

Old implants above the muscle should probably be replaced

While it is possible that you could go another 25 years without trouble with the implants, the fact that you are developing a capsular contracture suggests that it is a good time for new ones. These should probably go under the muscle. Discuss it with an experienced plastic surgeon since these are not routine cases. You have time to gather information and think about it, no urgency.
Richard Baxter, MD

Seattle Plastic Surgeon
+2

Repairing capsular constracture

It is true that anytime you have surgery for capsular contracture, it is possible for it to recurr.  But that being said, it is most likely that your grade II contracture will be much better and you will enjoy having soft looking AND feeling breasts.  Good luck!
Bivik Rajnikant Shah, MD

Columbus Plastic Surgeon
+2

When to replace your implants

Your implants are 25 year old silicone breast implants and the capsular contracture may represent a rupture.  Your mammograms may not show the rupture.  Your concerns of having a worse outcome after revision surgery is always present, however your surgeon can help you manage these risks.  Also, the new cohesive gel silicone implants we are using rupture less than the devices you currently have.
Vishnu Rumalla, MD

Dallas Plastic Surgeon
+2

25 year old silicone implants with capsular contracture

This is a difficult decision whether to replace them or not. Yes, another surgery could be worse if not carefully planned and executed. On the other hand your implants will continue to deteriorate with time. The wall will weaken and you may have a rupture with worsening capsular contracture. It is hard to tell when this will happen but if you wait long enough it will eventually. The surgery is easier before there is rupture of the implant. If the capsular contrature bothers you I would... more
Sheila Bond, MD

Montclair Plastic Surgeon
+2

Replace your 25 year old silicone implants

Twenty-five year old silicone breast implants should be replaced.  If you have capsular contracture developing, then there is a chance that your implants are ruptured even if the mammogram did not show it. Mammogram is NOT the test of choice to evaluate the integrity of a silicone implant shell. The best test is an MRI. However, if your implants are not ruptured now, it is very likely that they will be soon. If you were my patient, I would advise you to replace them now.... more
Kevin Brenner, MD

Los Angeles Plastic Surgeon
+2

Deciding whether or not to remove and replace old implants

Although it seems you're happy with mild capsular contractures, you're implants are pretty old.  I've exchanged old implants and discovered one or both was leaking or ruptured, even though it wasn't expected.  If the rupture is contained within the capsule, its messy, but not a big problem to fix.  It the rupture becomes extracapsular, the silicone in the surrounding tissues is often impossible to remove completely.  New silicone implants have better,... more
Douglas J. Mackenzie, MD

Santa Barbara Plastic Surgeon
+2

Treatment of capsular contractures

If your implants are hard enough to bother you, it is reasonable to replace them.  If not, leave them alone for now.  Just understand, these are old implants and the surgery will be far more complicated if they rupture.  In either case, new implants should be postioned in a new pocket under the pectoralis muscle to minimiize the risk of recurrent contractures.
Bruce Genter, MD

Abington Plastic Surgeon
+2

To replace or NOT Replace 25 year old scarred Breast Implants?

Regarding: "25 Year Old Silicone Implants w/ Capsular Contracture - Replace? I have 25 year old silicone implants over the muscle with Baker Grade II capsular contracture. I have just had a mammogram which showed no obvious leaks. I am torn trying to decide whether to replace them as they still look pretty good but just feel pretty hard. I would be devastated to go thru all that and come out looking worse or the cc recurs at a worse Grade than before." I think you... more
Peter A. Aldea, MD

Memphis Plastic Surgeon
+2

Moving Implants to Retromuscular Location May Improve Capsular Contracture

A grade 2 capsular contracture is usually not terribly bothersome.  However, if you want it improved, you will likely accomplish very little simply with implant replacement.  The implants should be moved to a different pocket when treating capsular contracture operatively.  In your case this would mean moving them to a laction under your muscle which also usually has a lower rate of contracture.
John Whitt, MD

Louisville Plastic Surgeon
+2

Replacing your breast implants

Sometimes, we operate under the premise, "if it ain't broke, don't fix it." This can apply to your situation, but you need to ask yourself a few questions.  Do my implants bother me? Do I like the size? Is there something that can be done to make them look better/feel softer/more youthful.  Most of these questions can be best addressed by consulting with a Board Certified Plastic Surgeon.  Most of the time when I see a patient in your position, we do some... more
Allan J. Parungao, MD

Oak Brook Plastic Surgeon
+2

Replacing old breast implants

If you have cc above the muscle it would bereasonable to take the old ones out and the capsules and go in with new ones under the muscle.  Go only to a very experienced surgeon for this.
Richard P. Rand, MD, FACS

Seattle Plastic Surgeon

www.randcosmeticsurgery.com

+1

I would replace them

I would replace them. I think renoval (implants and capsule) and replacement of the new implants submuscularly is the preferred surgical option. My concern with doing nothing is that your clinical situation can worsen. The surgery is easier before there is rupture of the prosthese. Finally, mammograms may not show the leak (or the rupture). If you consider doing nothing, I would make a MRI.
Enrique Etxeberria, MD

Spain Plastic Surgeon
+1

Breast Implant Revision?

In my opinion 25 year old silicone implants that look "pretty good" and feel "pretty hard" should be replaced despite the usual risks. Regardless of the mammogram findings, your implants could still be ruptured. If you decide not to have surgery, you may want to consider an MRI to be sure the implants are indeed intact. I would still go with the exchange to new silicone implants with capsulotomy/capsulectomy. Obviously, due to the many variables, a... more
Lawrence Shaw, MD

Scottsdale Plastic Surgeon

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