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Silicone Breast Implants Done in 1972. Recent MRI Completed - Remove or Leave Alone?

asked 1 year ago by roses7 in Vista
Latest answer by Farhad Rafizadeh, MD
Question viewed 795 times
Tags: silicone implant, MRI, options

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?

24 answers to Silicone Breast Implants Done in 1972. Recent MRI Completed - Remove or Leave Alone?

+2

Is it possible to remove a ruptured silicone implant which is confined to the capsule without silicone contamination of tissues.

I have removed many old silicone implants without contaminating the tissues. If one can make a large enough incision, it is easier to remove the capsule and the implant without opening the capsule. If I try to remove the implant through the insertion scar, I separate most of the capsule from the tissues then pack a pad around it to prevent contamination, open the capsule, remove the implant material and finally remove the capsule.
Farhad Rafizadeh, MD

Morristown Plastic Surgeon
+2

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... more
York Jay Yates, MD

Salt Lake City Plastic Surgeon
+1

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.
Arian Mowlavi, MD

Laguna Beach Plastic Surgeon
+1

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.
Brent Moelleken, MD

Beverly Hills Plastic Surgeon
+1

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
Babak Dadvand, MD

Los Angeles Plastic Surgeon
+1

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.
Otto Joseph Placik, MD

Chicago Plastic Surgeon
+1

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
Talmage J. Raine, MD

Chicago Plastic Surgeon
+1

Bilateral Implant Ruptures

Dear Roses7, 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... more
S.Pasquale Maggi, MD

Austin Plastic Surgeon
+1

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... more
Martin Jugenburg, MD

Toronto Plastic Surgeon

www.torontosurgery.ca

+1

Likelihood of intact implant and capsule removal

Roses, 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! see video
Kenneth R. Francis, MD

Manhattan Plastic Surgeon

www.francisnyplasticsurgery.com

+1

Breast implants

En-bloc removal is possible but unlikely.  I would definitely recommend the removal of the implants along with capsulectomies.
Shahin Javaheri, MD

San Francisco Plastic Surgeon
+1

People need to give up on "en bloc" implant removal

Unless you are willing to have a HUGE incision, there is no way to do an en bloc implant removal.  The incision would need to be long enough to take the implant and capsule out as a whole (en bloc).  So it would be longer than the diameter of your combined implant and capsule.  Think of it as taking a softball out of your breast, you need a huge scar to do it. Somehow this idea has been promoted enough that patients mistakenly think it is better.  The usual way to... more
Richard P. Rand, MD, FACS

Seattle Plastic Surgeon
+1

Old Leaking Silicone Breast Implants Should Be Replaced

After nearly 40 years of presumed good use, your breast implants can certainly stand to be removed and replaced. Although if you are content with how they feel and look, there certainly is nothing wrong with leaving them alone. Should you desire to remove them, total capsulectomies can be performed with relatively clean removal of any loose silicone. New breast implants can then be immediately replaced if you desire. This is a straightforward procedure that will most likely surprise you on... more
Barry L. Eppley, MD, DMD

Indianapolis Plastic Surgeon

www.eppleyplasticsurgery.com

+1

What to do with ruptured 38 year old implants

Given their age of over 38 years, there is no doubt that these silicone implants need to be removed - along with the surrounding capsule and any free silicone (as much as possible). Depending on your specific situation, either new implants can be placed at that time or at a later date.
Steven Turkeltaub, MD

Scottsdale Plastic Surgeon
+1

Remove or Replace If Implant Is Leaking

With the evidence of the leak, even if intracapsuular, you would be well advised to remove the implants with capsulectomy. You may elect to replace the implants at the same time, or leave them out.
Paul C. Zwiebel, MD

Denver Plastic Surgeon

www.pzwiebel.com

+1

Removal of the broken implants, the scar capsule and any loose silicone will make a big improvement

The implants made in the 70s were very thin walled and had very liquid silicone gel. Essentially all of them have failed and need to be removed with the over lying scar and any loose silicone or silicone granulomas. The good news is that this should be relatively easy from your description  of your breast. Along with this you could have a breast lift or new and much better implants or both. Interestingly  my patients like you feel so much better after surgery because their breast... more
Carl W. "Rick" Lentz III, MD

Daytona Beach Plastic Surgeon
+1

Leaking Silicone Breast Implants SHOULD be Replaced or Removed

Leaking Silicone Breast Implants should be removed or replaced. In all such cases the surgeons tried to separate the implant scar envelope (capsule) from the adjacent tissue and remove the implant and its spilled content EN BLOCK. However, that is not always possible and sometimes entry is made into the capsule forcing the spilled silicone to be suctioned or removed by hand. Either way, the pocket is then washed, removing all contents and either a new implant is placed or it is closed... more
Peter A. Aldea, MD

Memphis Plastic Surgeon
+1

Silicone Breast Implants Done in 1972. Recent MRI Completed - Remove or Leave Alone?

You need to see in person a boarded surgeon to discuss. I would exchange in my practice. From MIAMI Dr. darryl J> Blinski
Darryl J. Blinski, MD

Miami Plastic Surgeon
+1

MRI with ruptured implant

The goal with removal of a silicone implant is to remove it witht he capsule intact. Of course, this is not always possible to be intact.
Steven Wallach, MD

Manhattan Plastic Surgeon
+1

Worn silicone gel breast implants, remove or not

After 30 years, it can be expected that most silicone gel breast implants will have developed a leak in the outer shell, and the silicone gel inside will leak into the scar capsule formed around the breast implant. The MRI may help you reach a decision, however the result is hardly a surprise. The implant can be replaced when you are 'ready' though as the gel contacts the capsule you may experience a drawing sensation and firming of the implant. Over time the capsule will calcify.... more
Peter E. Johnson, MD

Chicago Plastic Surgeon

www.peterejohnsonmd.com

+1

Removing ruptured implants

If the implant is ruptured, then it is recommended that you have them removed or replaced.  However, this is not an emergency and you should take the time to consider your options and optimize your health for surgery.   Good Luck.
David Shafer, MD

New York Plastic Surgeon
+1

Ruptured Silicone Implants

It is not unusual to have a silicone implant found to be ruptured after being in place for nearly 40 years.  I personally am comfortable leaving these implants alone if they are otherwise okay and have no evidence of parenchymal leakage.  The periprostetic capsule will likely keep the silicone within it and out of the tissue.
John Whitt, MD

Louisville Plastic Surgeon
+1

Remove them

As long as your health is okay I would recommend removing them.  You can replace them or leave them out depending on the circumstance of the remaining breast tissue.  Implants in for this period of time will usually be hard, contracted, calcified and quite uncomfortable.  Why live with them like this when you could enjoy a new nicer set of implants which would be softer, more comfortable and more physically appropriate and pleasing?
Kimberly A. Henry, MD

Greenbrae Plastic Surgeon
+1

You will ned to have implant removal

The implant rupture is close to  100% for the implants more than 20 year old. looks like you have contarcture and the best thing is to remove the implants and capsule. There is no emergency, but if you have symptoms it is the time to remove them. You have multiple option including no implants, saline or silicone implants or fat grafting.
Kamran Khoobehi, MD

New Orleans Plastic Surgeon

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