How long can I wait for surgery on ruptured silicone implant?

Question

I recently had an ultrasound that reported "signs of intracapsular rupture in right breast and capsule degeneration". I have no symptoms, although now that I know about it I feel every little pain and discomfort and my nipple is starting to hurt/burn. Can I wait until April (17 weeks) to have them replaced? And can I still run and do 40kg weights in the meantime? I have 410cc Natrelle allergan anatomical, textured, silicone implants, placed dual plane in 2014.

Kenneth Hughes, MD · Answer

Capsulectomy does not have to be performed in the instance of thin, pliable capsules.  Leaving a capsule behind is preferred if it is thin and pliable because of risks of bleeding and fluid collection. If there are calcific components, or silicone granulomatous material, or if the capsule is deforming the breast tissue, then removal of the capsule may be warranted.  A number of scientific studies have demonstrated the safety of silicone implants; yet, many patients continue to have anxiety about their use.  Removing silicone implants under local anesthesia is appropriate only in the simplest case of pure removal.  Usually removing them and performing the lift at the same time makes the most sense as some patients clearly need a lift.

Ronald J. Edelson, MD · Answer

An MRI is much better at picking up implant rupture than ultrasound so I recommend you consider that. An ultrasound can have false findings and you don’t want unnecessary surgery. I recommend you consult with a surgeon regarding how you should proceed.  There is no urgency. Wait until you have the information you need.

Daniel Barrett, MD · Answer

Dear Humorous3393,
newer generation of silicone implants are made of cohesive gel so they won't leak and spread. But still, most plastic surgeons recommend removal of implants as soon as possible in order to prevent possible complications. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Connie Hiers, MD, FACS · Answer

An ultrasound with mammagram is about 90 percent accurate in detecting a rupture. You might want to consider a MRI for a better view. Since you have the "new gel" implants, there is not a big hurry on removal if you are comfortable.

Kamran Khoobehi, MD · Answer

You have symptoms and finding of silicone implant rupture plus texture implants. I would recommend removal sooner than later. Please see your local board certified plastic surgeon for in person evaluation.

Tom J. Pousti, MD · Answer

There are no universally accepted "universal guidelines" when it comes to timing or urgency of removal of ruptured silicone gel breast implants.   We simply do not understand the exact effects that "free silicone" can have on surrounding tissues. Therefore, I advise patients to have rupture silicone gel breast implants removed as soon as reasonably possible (not an emergency but not "elective" either). Sorry I cannot be more specific as to your April timeframe. Best wishes.

How long can I wait for surgery on ruptured silicone implant?

Answers (6)

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