I have had a ruptured Silicone Breast Implant for several years. I got the implants in 1979 and haven't had any problems with them until I changed doctors. While I was taking my records to the new facility, I read a report from two years ago the I had a ruptured right implant. So, it has been leaking for two years. After reading horror stories on the Internet I am afraid that this has put my health at risk. Should I have some type of test to determine where the silicone has gone to and have them removed?
Ruptured Breast Implant: Test to Locate Silicone?
Doctor Answers 13
Relax, silicone implants are approved by the FDA and are considered safe!
Please take a deep breath and relax! You are certainly not alone in experiencing a silent rupture of your silicone breast implant. Silicone implants are approved by the FDA and are considered safe. 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.
Breast implants, like most medical devices, are not meant to last a lifetime, and I advise our prospective patients that replacement will likely occur sometime over their life time. The best test for looking at the ruptured implant and silicone material is the MRI.
As pointed out by the other physicians, silicone migration is extremely limited. I would strongly advise you to see a board certified plastic surgeon that is experienced in breast surgery in order to have the old implant and implant silicone material removed.
A thorough medical history and physical examination will be performed and a surgical plan formulated specifically for you. Obviously, you will need to decide if you wish to have replacement with new implants.
Thanks for your question.
Most plastic surgeons (and the FDA) would agree that ruptured silicone gel implants should be removed. Many patients at that point choose to have a lift, to leave the implants out, or to replace them.
The vast majority of silicone is usually fairly easily removed at the time of surgery, as the silicone is almost always confined to the capsule. It is often important to perform a complete removal of the capsule at the time of surgery to accomplish this, not just remove the implants, since silicone may have infiltrated the capsule (scar tissue around the implant).
The vast majority of patients are fine after removal of this scar tissue and their ruptured implant.
MRI detects best the presence of ruptured silicone implants and silicone near the capsule.
No specific test
There is no specific test to look at systemic levels of silicone in your body after a ruptured implant. If you have a suspicious mass it should be biopsied. Sometimes lymph nodes can accumulate some of the leaking silicone and that can cause the lymph node to enlarge (these would typically be in your axilla). If there is not a specific mass then likely the treatment would be to remove the ruptured implant and the scar tissue formed around the implant.
I hope this helps.
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A ruptured silicone gel implant is not a threat to your health.
Remain calm. Your implant was noted to have failed 2 years ago but may have failed much sooner (the failure was detected 2 years ago). The silicone that has escaped from the implant is going nowhere. The capsule around the implant will contain it. You should have your implants replace at the next convenient time. You are in no danger, however, so don't lose any sleep.
Silicone in your tissues does not cause any diseases.
A ruptured silicone implant will not make you sick, but it should be replaced promptly anyway because it is a defective device. You need an MRI of your breasts to determine where the silicone has gone.
You should have both implants replaced because they are old. Any leaking silicone that is easy to remove, should be removed at the same time. But if some silicone stays in your tissues permanently, it will not harm you.
MRI is best, but may not help with decisions...
I agree with Dr. Yuan that of available studies, MRI is best to evaluate your situation.
The real question, though, is whether it will really change the recommended management or what you would do. Your implants are close to thirty years old, and you have confirmed rupture- because we know that the more time that passes the more likely you are to experience extra-capsular leakage and silicone migration, I would usually recommend removal to patients like yourself. Other surgeons recommend not doing anything until you have to, but I believe in prevention of problems if possible.
I would discuss this with your surgeon and talk about MRI versus proceeding with removal.
No test to locate leaking silicone
There is no test to locate silicone. And it is unlikely that silicone would cause and problem other than local symptoms such as breast asymmetry for firm nodules.
MRI will only tell you about the scar and silicone
An MRI will not tell you anything more than there is scar and maybe silicone in certain places. If you know the implant is ruptured, then removal and possible replacement with a "cleanout" is in order. Don't waste money on tests that don't add useful information to this.
There are two kinds of ruptures
There are two kinds of ruptures of a gel implant and which one you have depends on whether the gel has remained within the scar wall your body made around the implant (intracapsular rupture) or if it has escaped outside of the scar wall (extracapsular rupture).
This can usually be determined by mammogram and ultrasound. Rarely, an MRI might be necessary. At the time of surgery, an effort is made to remove all of your gel but once in a rare while, it is not possible to get it all out. Fortunately, this has not been shown to pose a signifiant health risk to you. Removal of a ruptured implant is recommended but it is not an emergency.