MRI:Rt Breast-small zone of posterior contained intracapsular implant rupture,subcentimeter area.No evidence for parenchymal silicone or gel bleed.Medial capsular contracture & water density infiltration but no rupture.Left Breast-Definite positive keyhole findings of contained intracapsular implant rupture w/out evidence for parenchymal silicone deposition. Both-No evidence for implant collapse.What is potential of en-Bloc removal w/no breakage,fully clean area&replace w/new silicone implants?
Silicone Breast Implants Done in 1972. Recent MRI Completed - Remove or Leave Alone?
Doctor Answers (24)
Is it possible to remove a ruptured silicone implant which is confined to the capsule without silicone contamination of tissues.
Silicone implant failure
Failure of the implant is an indication to have it removed and replaced. For extracapsular rupture, this is a more pressing issue. Intracapsular rupture can cause capsular contracture, breast distortion, and can progress to extracapsular rupture. Removing all of the implant material requires careful capsulectomy. The capsule is removed with the implant and material contained within the capsule.
Read my blog post below for more details on silicone implant rupture.
Dr. York Yates - Utah.
Intracapular rupture of silicone implants
Although an intracapsular silicone implant rupture will not necessarily result in silicone leaking through out your body, it is recognized that silicone rupture will result in silicone molecules in the capsule promoting capsule thickness that will eventually deform your breast. It is a good idea to remove any ruptured implants as soon as possible.
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Old ruptured silicone gel implants
It is advisable to have the implants removed, and replaced if desired, if they are ruptured. old implants were of poorer quality and often had liquid silicone inside them rather than the semi-cohesive silicone now used.
Often, if women have gained weight over the years and their breast size is larger, it is possible to remove the implants completely and perform a breast lift.
Ruptured Silicone Implants
The potential for en-bloc removal of the implants is higher if they were placed above the muscle. Nonetheless, whether or not en bloc removal is possible, if there is a diagnosis of silicone implant rupture you should have the implants removed.
Hope that helps and good luck!
Dr. Babak Dadvand
Silicone Breast Implants Done in 1972. Recent MRI Completed - Remove or Leave Alone En bloc
In simple terms the possiblity of removing the vast majority (but not 100%) of the silicone remains an option. However, please realize that a ruptured implant should be identiifed and removed.
Breast augmentation implant rupture
With your MRI result I would recomend an enBloc removal and probable replacement with a new implant. Leaving the implant out will lead to excessive sagging of the skin. Size of implant chosen may differ depending on the measurements of chest diameter, which may have changed after all of these years.
Wishing you all the best
Bilateral Implant Ruptures
Silicon gel implants that have ruptured, should be surgically removed once the problem is identified.
The goal is to always remove both the failed implant(s), and also as much of the tissue capsule that surrounds the implant- this is termed a capsulectomy. The goal in this procedure is to remove the tissue, and the failed implant with the least amount of spillage of the silicone gel as is technically possible. The smaller the incision that is made the more difficult the procedure becomes.
I hope this helped,
Sergio Pasquale Maggi, M.D., F.A.C.S.
MRI findings shows breast implant rupture
Given your MRI findings I would recommend implant exchange with capsule removal. En bloc would be the goal but it is very difficult not to break the capsule. That, however, is not a reason to worry or delay the surgery.
The implants are old, they have a rupture, and you do have a capsular contracture. Exchange for new implants that should last long(er) now will give you a piece of mind that you do not have a leaking implant. It will also give you the opportunity to have the capsular contracture corrected.
Martin Jugenburg, MD
Likelihood of intact implant and capsule removal
The likelihood of en bloc intact removal of your implants and capsules together is not great. However, since the implants are both leaking, they should be removed. Violation of the capsule during removal doesn't exclude immediate replacement. New implants can indeed be placed at the time of removal even if some silicone spills out. Good luck!