I had Silicone breast injections 7 years ago. Now, I can feel lumps on both sides but without pain. I never also have not had (thankfully) deformity or whatsoever. I would like to remove the injected liquid and get a Breast implants after, is that possible? I have had several ultrasounds and my doctor said it's nothing, but I didn't infrom her about the procedure I had. I also recently consulted a cosmetic surgeon here and was denied for the procedure. I need help, I need a doctor who can help me.
Removing Silicone Breast Injections and Get Implants After?
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Doctor Answers 13
Silicone injections into the breast
This can be a very difficult problem sometimes requiring a mastectomy and followed by a breast reconstruction. It really depends upon the amount of injury and the quantitiy of injected material. MRI may be helpful to first analyze what is in yoru breast.
Careful assessment required
I have dealt with silicone injected breasts on many occasions and currently have four patients that I have seen recently that went through various forms of excisions/mastectomies. The effects of silicone injections often do not show up for years so your situation is bound to get worse rather than better. Unfortunately, when the silicone is soft, one cannot often tell where it is. However, when they form hard lumps, it is obvious but more damaging to the normal tissue.
It is possible and necessary to perform some sort mastectomy or breast excision whether it be segmental, subcutaneous, simple or any other variation. How to reconstruct is dependent on what is left behind and what you want as your end result. Many of my patients go through a stage of tissue expanders that are used either as a temporary spacer to give the tissues time to recover from the surgery before doing the final reconstruction, or they are used to stretch the skin in the event the skin is damaged enough to have to remove. Each patient has to be assessed carefully and individually.
Partial of full mastectomy with breast reconstruction is the answer
Silicone injections in various parts of the body has been done quite frequently all over the country. The difficulty with silicone injections begins with the quality of the silicone itself. I have seen many cases where industrial grade silicone has been injected inside the human body. This can be a tremendous disaster. Problems can include infections, granulomas, cellulitis, and persistent skin infections, disfigurement and skin dimpling. It is very easy to have silicone injected, but very difficult to have it removed. The removal can frequently be very complex and involved lengthy surgery. Multiple operation is not uncommon. It is not uncommon to expect scars in locations that would otherwise be undesirable. If you do have silicone, or are having problem with silicone that was injected by a non-healthcare provider then you should certainly seek medical attention. Some solutions include IV antibiotics, oral antibiotics and surgery after the inflammation has subsided. Removing the silicone is not just a cosmetic issue but also an issue of better health. Depending on the type of silicone injected concerns with autoimmune diseases and infections are foremost. Taking medications such as ibuprofen or cortisone is only a temporary measure. The real solution is surgery. Not all plastic surgeons are willing to operate on patients who have had silicone injected in their body. Many of these cases are not covered by insurance because they were performed for cosmetic reasons. My recommendation to anyone that has had silicone injections and wishes to have it removed, is to seek a board certified plastic surgeon who is likely willing to do more than 1 operation as well as willing to do some of these operations in a hospital setting. I have had patients visit me for removal of silicone and the discussion to proceed is never an easy one.
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Silicone Breast Injections
Silicone nodularity after silicone breast injections is described in the literature. Most of these nodules should be assessed to rule out tumors or granuloma. There are several ways to remove the individual nodules, but this requires the expertise of a surgeon who is familiar with these techniques.
Do not have silicone injected into your breasts
Anyone reading this, please do not have silicone injected into your breasts. This is very different than having silicone implants, which are very safe. Injections are very difficult to remove and it actually is considered a reconstructive procedure requiring extensive surgery and possible deformity to correct, if possible. At this point, I agree that you should see a reconstructive breast surgeon. Good luck.
See a breast reconstruction surgeon
This is a VERY difficult problem to treat. Injected silicone typically produces granulomas (hard lumps) throughout the breast many years later (5-30). When a patient presents with this problem, it is very commonly treated by surgical removal of the silicone, along with any breast tissue or skin that is stuck to the silicone. At the end of the procedure, it would resemble something between a lumpectomy (removal of a small lump for biopsy) or a mastectomy (removal of the entire breast). That really just depends on how much silicone you have.
The best advice to give you is to find a good breast reconstruction surgeon and a good breast surgeon (general surgeon) who can start taking care of your problem. Good luck!
There are several possibilities.
What you need is entirely dependent on the person who did the injections and how that person did them. There are essentially two methods of doing silicone injections. One is to inject under the breast, on top of the muscle, attempting to lift the breast and leave the silicone in one mass very much like a retroglandular breast implant, just without the shell surrounding the gel. The other is to just inject the silicone into the breast wherever it will go easily. I have seen it done both ways. Since you have had so few problems, you may have had the former. The latter frequently results in multiple nodules and some of the silicone will frequently migrate. How the silicone was injected also impacts what you can do to remove it. The former can frequently be removed by removing the scar capsule around the silicone and any areas outside the main mass. This can then be treated like an exchange of implants. In the later case, you will frequently have to remove a large percent of the breast and treat it like a breast reconstruction. Although an MRI is the ideal method of visualizing the silicone, a mammogram will frequently tell you all you need to know to predict what has to be done to remove all the silicone material. The ultrasound you had may also provide this information. As far as the “cosmetic surgeon” you saw, this is probably the wrong person to see. Who you need is a board certified Plastic Surgeon with broad experience in breast reconstruction. Because this problem is, thankfully, rare these days, you probably also need an older surgeon who has seen this problem multiple times before. Start at the American Society of Plastic Surgeons web site (www.PlasticSurgery.org) and then look at the individual surgeon’s web site for further information, or ask your gynecologist or family doctor for a recommendation.
No easy solution for problems with silicone injections into the breast.
There is no easy solution to the problem.
If the silicone can be localized than it can be excised. However, this is unlikely. Unfortunately the silicone is a thick gummy like substance that is difficult to remove when injected. This is very different from breast implants that generally contain the vast majority of the silicone when ruptured. Also the silicone in current breast implants is very thick and generally stays together as a mass..
It occasionally forms a cyst which can be excised but more likely it spreads through the tissues and becomes almost indistiguishable from the breast tissue.
The only effective way to remove all the silicone may be to get a subcutaneous mastectomy and no one really wants to do this for benign desease. This is the reason, you may find it difficult to find a surgeon to perform the procedure. After this, you would essentially need a reconstructive procedure to restore the shape of the breast.
Check out the lumps first
The first thing you need to do is find out what the lumps are. The usual sequence of mammogram, ultrasound and MRI should let your Dr. know what you are dealing with. After that there are many options from doing nothing to doing a mastectomy with reconstruction.
Whoever you see should be able to give you all your options, the advantages and disadvantges of the options and their recomendations.
First things first
Before committing to any course of action:
1. Get an MRI to show the extent and distribution of the injected silicon. That will dictate what kind of excision surgery will be needed.
2. Get more than one opinion from Board certified surgeons from the American Board of Plastic Surgery (go to www.plasticsurgery.org for listings of surgeons near you)
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.