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Ruptured Implant and Silicone in Lymph Node

Should ruptured silicone implants in the lymph nodes be removed as soon as possible? Can the implants be replaced? Some doctors say the silicone isn't harmful, and there's no rush to remove/replace the implants if they're not bothersome. Is this true? What can be done?

Asked 39 months ago by Mommyx2 in Southern Calif.

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Implant Rupture

Ruptured implants should be removed. The silicone can cause granuloma formation which in and of itself is not dangerous but makes it more difficult to remove later. I'm not sure what you mean by "rupture silicone in the lymph nodes" since the silicone should not be in the lymph nodes.

Jacob Freiman, MD

Miami Beach Plastic Surgeon

Lymph nodes and ruptured silicone gel implant

A ruptured implant should be replaced at a convenient time for the patient. It is not an emergency and will cause no long term health problems. The silicone will be contained by the capsule that forms around all breast implants. It is unnecessay to remove lymph nodes if silicone is suspected. Probably everyone in this country has molecular silicone in a lymph node somewhere. Injection needles are lubricated with silicone so anytime you get a medical injection or IV, some silicone is shed... more

Vincent N. Zubowicz, MD

Atlanta Plastic Surgeon

ASAPS ASPS

Remove silicone implants when ruptured

The treatment depends on which silicone implant was utlized. The more cohesive gel impants are quite firm and do not easily spread when ruptured. However, the less cohesive gell implants can diffuse throughout the breasts. This can be quite a mess to clean up. Therefore it is best for you to find and treat these as soon as possible.

Otto Joseph Placik, MD

Chicago Plastic Surgeon

ASAPS ASPS

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.

Steven Wallach, MD

Manhattan Plastic Surgeon

ASAPS ASPS

Time is on your side.

Science has demonstrated that the silicone is not threat to you or your health. The silicone will be taken up by lymph nodes in the area, and can be easily visualized on X-rays, and MRI's. What to do? Find a plastic surgeon you trust. Discuss your options. They will include- removal of implants & capsues or replacement of implants with silicone or saline implants +/- capsule work, plus any other aesthetic adjustments the breast needs.You may be covered under the warranty if you are... more

Scott E. Kasden, MD

Dallas Plastic Surgeon

ASAPS ASPS

Ruptured Silicone Implants probably should be removed.

Breast implants, like most medical devices, are not meant to last a lifetime. I advise our prospective patients that replacement will likely occur sometime over their life time. In 1999, the Institute of Medicine concluded that silicone implants do not cause any major health problems. Research and reports from the last decade have shown that silicone gel-filled implants do not pose additional risk to women’s short-term or long-term health. Most plastic surgeons would recommend... more

Stephen A. Goldstein, MD

Denver Plastic Surgeon

ASAPS ASPS

I would always recommend removal

I agree- if the implants are known to be ruptured, nothing good is going to come from leaving them in place. I wouldn't want you to think that dealing with the issue is an emergency, but the longer the silicone material is allowed to stay in place, the greater the chances of further silicone migration to lymph nodes or other locations. This further migration will only make further diagnostic maneuvers necessary in order to rule out more serious problems like breast cancer- maneuvers you... more

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Armando Soto, MD

Orlando Plastic Surgeon

ASAPS ASPS

Ruptured implants

Current recommendations are to replace or remove ruptured implants. While studies have shown that there is likely no significant _systemic_ harm from leaking silicone the silicone itself can cause local inflammation which can lead to scar tissue and other local problems over time. And as Dr. Freund and Dr. Karamanoukian have pointed out - it is important that any new lump in your breast or armpit be evaluated to rule-out breast cancer. Don't assume it is from the silicone. I hope this... more

Steven H. Williams, MD

San Francisco Plastic Surgeon

ASPS

Silicone in the Lymph Nodes after Breast Augmentation

Axillary (armpit) lymph nodes most commonly occur following infection of the arm or upper extremity. They can occur from infection, cancer, and less commonly, from a ruptured silicone implant in the breast. Lymph nodes in the armpit should never be ignored and must undergo complete evaluation to rule out malignancy. It should never be assumed that the lymph nodes are a result of a ruptured silicone implant. Seek the attention of a qualified plastic surgeon or general surgeon to examine... more

Raffy Karamanoukian, MD

Los Angeles Plastic Surgeon

Ruptured implants should be removed and/or replaced.

Hello, Remove the implants with the capsules and consider replacement with saline versus silicone-filled implants if you wish. As long as the skin/breast tissue integrity is OK, this should be possible. You need to be properly evaluated by a qualified board certified plastic surgeon to get this sorted out. Best Regards, John Di Saia MD

John P. Di Saia, MD

Orange Plastic Surgeon

False breast exam findings

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... more

Robert M. Freund, MD

New York Plastic Surgeon

ASPS

The current recommendations are to replace the ruptured implants

Although there are no system diseases that have been associated with ruptured implants the long term fate of silicone from ruptured implants is not completely known. With more research it maybe shown that there is no harm in leaving ruputered implants long term. We do not have data to support that. Therefore the current recommendations is to replace ruptured implants.Although this is not an emergency, the generalized feeling is that it should be scheduled in a timely fashion to replace the... more

Andrew Y. Kleinman, MD

Westchester Plastic Surgeon

ASPS

See your local board certified plastic surgeon

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... more

Doctor's Website

Kenneth R. Francis, MD

Manhattan Plastic Surgeon

ASAPS ASPS

Not an emergency, but should be done

If you have an "extracapsular" rupture of an old silicone implant with extravasated gel in the tissues or lymph nodes, it is best to have the implants and capsules removed and as much of the escaped gel excised as would be safe to remove. There is no known danger from the material so it is not wise to get close to vital structures in an effort to remove all ofthe gel that have traveled into the armpit for example. You can have new implants placed at the same time.

Richard P. Rand, MD, FACS

Seattle Plastic Surgeon

ASAPS ASPS

It's Node Unusual

The presence of silicone in the lymph nodes is not unusual after breast augmentation. Sub-microscopic particles of silicone may pass through the intact envelope of a silicone gel implant, and eventually these silicone molecules are filtered by the lymph nodes, which is their purpose. If a silicone gel implant is ruptured, there may be a much greater amount of molecular silicone that is exposed to your body, since there is no longer the outer silicone rubber shell of the implant acting as a... more

Athleo Louis Cambre, MD

Los Angeles Plastic Surgeon

ASAPS ASPS

Silent rupture dilemma

The controversy regarding systemic auto-immune diseases being caused by silicone gel breast implants have been adequately put to rest. They don't. If you are suggesting that silicone was detected in your axillary lymph nodes and thus led to or confirmed the diagnosis of ruptured implants, then it is not necessary to remove the nodes themselves if they are not inflamed. The difficult question is what to do with intracapsular (gel remains inside the natural capsule of scar tissue) silent... more

Robin T.W. Yuan, MD

Beverly Hills Plastic Surgeon

ASPS

Silicone does not cause any illnesses.

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.

George J. Beraka, MD

Manhattan Plastic Surgeon

ASAPS ASPS

Ruptured silicone implants should be removed.

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... more

David Shafer, MD

New York Plastic Surgeon

ASPS

Silicone Implant Rupture and Exchange

Silicone does not pose any real health risk. Numerous studies over the past 20 years, including several of my own, have clearly demonstrated this. So, there is no urgent need for implant removal. However, silicone migration to the lymph nodes can cause inflammation and scarring which could become a source of discomfort. Implant exchange, following MRI-proven rupture, can easily be performed.