Removing Silicone Breast Injections and Get Implants After?

Question

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.

David Shafer, MD, FACS · Answer

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.

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding removal of silicone injections from the breast with subsequent breast reconstruction. I would highly suggest you have the silicone injections removed as soon as possible. Silicone is highly reactive and causes a whole host of immune responses. In the breast, it can cause severe scarring and can possibly even increase chances of cancer. Therefore, I suggest you have the silicone removed as soon as possible. This can be done through an incision on the breast. Most of the time I reconstruct the breast at the same time with insertion of a breast implant. However, if you have extensive silicone it may require removal of the silicone then, waiting 4-6 months to return for breast reconstruction with implants. However, in the majority of cases I am able to remove all the silicone (or at least the majority of the silicone) and then undergo breast reconstruction with breast implants. Thank you for your question regarding removing silicone injections into the breasts.  
I specialize in silicone removal and subsequent reconstruction.  I am the Director and chief clinical investigator at the Institute of Silicone Removal.  Since removing silicone is a big procedure, please seek an experienced, board certified plastic surgeon with significant experience in removing silicone.  Do your research.  Make sure they have performed many silicone removal surgeries and have the before and after pictures to prove it.  Carefully examine their before and after pictures and check their reviews on RealSelf.   If you cannot find an experienced, silicone removal surgeon in your neighborhood, consider traveling out of state if you must. Sincerely, Dr. Katzen. (“Verified” Plastic Surgeon, President of the American Society of Bariatric Surgeons, Certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, and International College of Surgery and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery, RealSelf Hall of Fame, and RealSelf Doctor Advisory Board for Medical Review and Consumer Panel.)

Jeremy S. Nikfarjam, MD · Answer

Thank you for sharing your experience. You're not alone in this, and there is a path forward, but it’s important to be informed and work with the right kind of surgeon. Silicone injections can migrate, inflame surrounding tissues, and create lumps, granulomas, or fibrosis, often years later. Even without pain or deformity now, changes can develop over time. It sounds like your doctor couldn’t properly assess your imaging because they didn’t know about the injections. This is very important. Ultrasounds and MRIs must be interpreted with your history in mind, especially when silicone is involved, because it may be mistaken for benign fat or fibrous tissue without the right clinical context.
Removal of silicone requires a specialist in excisional silicone removal, especially from the breast. This is not a common skill among general plastic surgeons or even cosmetic surgeons. The procedure involves meticulous dissection to excise as much of the silicone and affected tissue as possible then reconstruction of the breast (which could include a lift, fat grafting, or later implants). The first stage of surgery would include removal of silicone and inflamed tissue. The second stage (3–6 months later) would be for breast reconstruction and/or implant placement.

You are not alone. Many women have gone through this quietly and successfully. It just requires the right specialist and honest planning. I am a board-certified plastic and reconstructive surgeon with a specialized focus on silicone and biopolymer removal. Over the years, I have dedicated my practice to safely addressing complications arising from these materials. Recognizing the unique challenges they pose, I developed a removal and reconstruction technique that is designed to ensure the most complete removal possible while minimizing risks and optimizing patient outcomes. I'd be happy to see you for a clinical evaluation whether it be complimentary virtual consultation or an in-office appointment to discuss your options.   Please note – insurance can cover these procedures if your plan holds out of network coverage and the procedure is deemed medically necessary. My Silicone Coordinator can look into existing coverage during your initial call. (516) 279-2616

Raffy Karamanoukian, MD, FACS · Answer

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. We remove liquid silicone injections and granulomas from the soft tissue and have had great results.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best,
Dr. Karamanoukian
Realself100 Surgeon

Otto Joseph Placik, MD · Answer

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.

Ricardo L. Rodriguez, MD · Answer

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 plasticsurgery.org for listings of surgeons near you)

Carlos Alberto Ríos García, MD · Answer

Regards, 
Liquid silicone is unsafe, please do not use it ever. The autoimmune response could be triggered by this substance, if you look around on the Internet, you will find patients that have a lot of problems with this product. The use for lips and other areas is off label. 
It is unfortunate the fact you have this substance injected into your breast tissues. It is really dangerous, even medical literature shows that patients could develope different kinds of breast cancer after breast liquid silicone injections. The conduct is to perform mastectomy and eventually manage the axillary nodes. Finally, a reconstruction with tissue expanders or flaps can be performed.
Biopolymers (liquid silicone, Poly Acrylamide Gel, PMMA, Macrolane, etc), ALWAYS should be
removed, because you could present at any time Iatrogenic Allogenosis and probably A.S.I.A.
syndrome. Please remember to be aware, do not let any permanenrt filler to be injected into your face, breast, buttocks, calfs, genitalia, etc. The safest way to increase buttocks is through your own fat injections or through silicone implants.
I hope the information was usefull, have a nice day! Dr Carlos Rios.

Raj S. Ambay, MD · 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.

Sirish Maddali, MD · Answer

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!

John P. Stratis, MD · Answer

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.

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