I want to know whether I should now remove my 40 year old silicone breast implants.

Breast implant removal should be performed with complete en bloc capsulectomy without lift. The capsule should not be left in place or the space will not heal. In patients that believe that their implants are causing them illness, leaving the capsule behind will not result in any improvement in their symptoms. Because the removal of the capsule and lift performed together can compromise the blood supply to the skin, breast and nipple to a potentially devastating degree, they should never be performed together. After the explantation with capsulectomy is healed, you can develop an plan for further surgery if it is warranted and is safe from a technical standpoint.

As you no longer want the implants and they are causing your breasts to feel hard, and are potentially ruptured it is a good idea to have them removed. Visit with a board certified plastic surgeon near you for a consultation. She/He will examine you to look for signs of concern including rupture. I've included a video I hope you find helpful.

Removal of breast implants, intact or ruptured, may have positive implications if patients are symptomatic. A constellation of symptoms associated with breast implant illness, and autoimmune disease are considered when treating patients who have breast implants and are concerned about foreign body reaction. In our office, we begin this journey with a consideration of symptoms and exclusion of obvious autoimmune problems. In many of our patients, en bloc removal of breast implants with capsulectomy is important and beneficial. Further clinical evidence about breast implant illness is evolving and will continue to guide treatment. I would suggest removal if there is a possibility of foreign body reaction.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Thank you for your question.  Unfortunately you have the first or second generation silicone implants that had weak shells.  We know that these implants are probably ruptured and that's why you have developed such aggressive capsular contracture.  The reason for removal is due to discomfort and it's a good idea to remove hard implants. These don't pose any health issues, however, given the nature of the issue, insurance companies can cover removal of the implant and capsule.  I am sure mammograms are very difficult and this is another reason why they should be removed so you can start getting more comfortable annual screenings.  Hope this helps and best of luck. 

Thank you for your question.  It sounds like you may have a  capsular contraction due to the description of your breasts being hard it is very common after many many years to develop this. It's much easier to comment on this if  you had provided photos and even better for an in person examination. I recommend that you see a board-certified plastic surgeon to assess whether or not you have a capsular contraction and treat you accordingly. I do recommend that you had your implants removed and either replaced or completely taken out due to preference.