Breast Implant Removal of 20 Year Old Polyurethane Implants

Question

In 1988, I had breast augmentation using the Polyurethane implants. I have had no problems at all with them for the last 20 years. I am however now seriously thinking of having them removed.

	They were placed under the muscle and I am wondering how safe is it to remove them? And is it any more difficult a post op phase than the initial surgery? I would appreciate hearing from any of you who have removed these types of implants and your post op results, or responses from patients. Thanks.

Kevin Brenner, MD, FACS · Answer

Your old polyurethane breast implants should be removed. Any twenty year old implants have a high liklihood of having rupture, and therefore should be removed and possibly replaced. Since the polyurethane coating has been reported to be incorporated into the surrounding breast capsule, removal of the implants should be performed in conjunction with a total peri-prosthetic capsulectomy, if possible. This is a bit more complicated than a straightforeward exchange of implants.

Jed H. Horowitz, MD, FACS · Answer

Good day! Generally after explantation, the shape and size of the breast will be unpredictable. Result varies between patients and it will largely depend upon their age, duration and size of the implant, or previous state of their breasts like existing anatomy, deformity, previous surgeries, underlying personal and family medical conditions, nicotine use, pregnancy and other factors. There are options available such as a lift or a fat transfer for a more natural approach, if you are worried about the explantation result and doesn't want new implants. Do not hesitate to contact your surgeon about options designed for your needs and discuss realistic goals and expectations. Best of luck! #RealSelf100

Otto Joseph Placik, MD · Answer

In my opinion, I would first obtain imaging to confirm implant integrity of lack of it. In the former, the implant can be extracted alone if the capsule is thin. However, in the case of intra/extracapsular rupture, I would perform a capulectomy as well.

Farbod Esmailian, MD · Answer

They are no more different removing than regular silicone implants. I would bet though that these are ruptured and removing them along with the capsule as whole would be the procedure of choice to prevent any spillage.

	One way of determining if they are ruptured would be to have an MRI, between even then they can give a false reading.

	Good luck.

Steven Wallach, MD · Answer

Ther should be no problem to remove polyurethane implants.  If the implant is ruptured it would be best to remove it with the capsule intact.

Carmen Kavali, MD · Answer

Absolutely, you may have them removed. It's not a bad idea to remove 20 year old polyurethane implants anyway. You would need a complete capsulectomy at the time of implant removal, which also means you would need a drain in each breast for a few days afterwards, to prevent fluid buildup inside. You may choose to have a lift at the same time, or you may choose to wait and see how your breast shape settles out first.

Pat Pazmino, MD, FACS · Answer

If you have had a breast augmentation with polyurethane implants, it is a good idea to remove these implants and receive a capsulectomy. At this time, you may choose to receive another set of breast implants either in the same position or in a different layer of your breast. Keep in mind that your previous set of breast implants have stretched out the overlying skin and breast tissue. If you do not receive another set of implants you may notice some depression or sagging of your breasts. This may be corrected with a second set of breast implants or a small breast lift.

John P. Di Saia, MD · Answer

It is safe to remove them. The real question is what will things look like afterward especially if you choose to remove them without replacement.  Usually things can be made to look OK. Sometimes this requires a breast lift.
Best Regards.

Richard P. Rand, MD, FACS (retired) · Answer

By this time, you just have a regular sommth walled silicone implant that can easily be removed. The polyurethane sponge coating of your implmat has long since been incorporated into the tissue surrounding the implant. If you don't have hard capsular contractures, the capsules don't need to be removed so the polyurethane isn't really an issue at all. There are many of the country's best plastic surgeons in Atlanta. Dr. Rod Hester has probably the nation's biggest experience with Replicon implants and you might want to contact him.

Breast Implant Removal of 20 Year Old Polyurethane Implants

Answers (9)