Removing poluurethane implants
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.
Removal of polyurethane covered implants
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.
Old Polyurethane Breast Implants Should Be Removed
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.
Removal of old polyurethane implants is safe
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.
Removal of breast implants with polyurethane implants
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.
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.
Removing Silicone Implants
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.
It can be done quite easily
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.