Silicone Implants 8 Years Ago. Breast Has Become Lumpy and Painful - Is It Dangerous?

Most likely you have developed signifcant amount of capsular contracture after having had breast augmentation with silicone implants. There is even the possibility that the implant might have ruptured. I have had at lease one patient with a cohesive type silicone implant who had parts of the implant break off and show up as a lump (see picture in web reference).

You need to be evaluated by a board certified plastics surgeon and have your implant evaluated with an MRI before considering your treatment options.

It sounds like your implant may have ruptures and you may have developed capsular contracture. Please see your surgeon as soon as possible. 

You should schedule a consultaiton with a certified plastic surgeon who would most likely obtain imaging studies such as an MRI to evaulate the breast and help plan surgery which most likley would require a capsulectomy and possible resection of extracapsular silicone

You may have a ruptured silicone breast implant which is causing you to have pain and a lump.  There are no health risks of this condition but you may consider surgery to have the implant and the scar tissue removed and replaced with a new implant.  This may also alleviate your painful symptoms.  This can be a more complicated surgery than your first one, especially if the contents of the implant have spread within the breast pocket or space surrounding the implant. The implant may need to be converted from above the pectoral muscle to below the pectoral muscle.

To confirm the diagnosis you can obtain an MRI, however if you are having pain, there isn't a great need for this study since you will likely have surgery to replace the implant due to your painful symptoms.

I recommend you consult with a board certified plastic surgeon for a comprehensive exam and a treatment plan of your options.

It sounds like you have a capsular contracture.  This is excessive scar tissue that forms around an implant.  The treatment involves removal of the capsule and/or change in the original pocket placement.  The best advice is to visit with a board certified plastic surgeon to get all of your options.

Dr. ES

It sounds like you might have a leaking silicone implant and subsequent breast tissue changes- capsular contracture. Seek out a board certified plastic surgery for an examination- he may request an ultrasound or other study to assess the integrity of the implant prior to replacement surgery.

You could have a rupture of your implant, or increases in scar tissue around your implant (capsular contracture). I would advise a visit to your plastic surgeon for evaluation. An imaging study such as mammogram or MRI may clarify your diagnosis. I recommend surgery to remove and replace implants in the situation of ruptures, but non urgently. I would also rule out any other issue that could require a more urgent treatment.

Lumpy implants?  Is not a goo thing.  You should have it checked out first by your surgeon then decide when to have them redone.

Regarding:  "Silicone Implants 8 Years Ago. Breast Has Become Lumpy and Painful - Is It Dangerous?
I had the cohesive sillicone gel implants in 2002. Over the past few months the left one has changed shape and become lumpy in various places and is painful. I was wondering if it is a matter of urgency that I have them replaced and will the following surgery be a much more complicated procedure?"

I sounds like you are either forming serious scar tissue around an intact left breast implant (Capsular Contracture - Baker class IV) or have a leaking implant WITH capsular contracture.

I am not sure what the breast implant warranties are like in the UK. In the US, both large implant manufacturers - Mentor and Natrelle (Allergan / Inamed / McGhan) have lifetime warranties and will supply you with a new set of implants IF they leaked. They will NOT do so if you have capsular contracture. For this reason, discuss this with your surgeon. You may want to have a MRI to demonstrate the presence of a leaking gel implant and know what your financial obligations are.

Unless you have associated redness, fever and other symptoms associated with an infection, a capsular contracture is not a surgical emergency. But - why would you want to live a long time in constant pain? When you DO decide to go ahead you will be faced with several options:
- remove the implants with scar tissue (capsulectomy). period.
- remove the implants with scar tissue (capsulectomy) and exchange them for either saline or gel implants placed in a NEOPECTORAL pocket (a pocket formed between the scar and the muscles).
- As above. But since the likelihood of developing another or bilateral capsular contracture is higher in women who already developed one, many surgeons would now use STRATTICE, an acellular dermal matrix, which would thicken the plane between implant and skin (hiding ripples), support the implants (to reduce sagging) and drastically lower the likelihood of recurrent scar formation. Strattice is expensive but NOT as expensive as having to go back in and deal with another capsular contracture.

As you can tell, this amply answers your question : "will the following surgery be a much more complicated procedure". If all you are having is implant removals - No, it will not be. But, if you are having anything else done, the operations are more complicated and more expensive.

Good Luck.

Dr. Peter Aldea

It sounds like your aging silicone implant has ruptured, leading to the lumps and pain you are feeling. At the very least, you should see a plastic surgeon to confirm the implant rupture and rule out other causes for your breast lumps and pain (infection, cancer, etc).  Once it's clear that an implant rupture is your issue, I would recommend removal sooner rather than later.  The symptoms you have won't improve, and they could worsen.  You will need a capsulectomy (removal of scar tissue around the implant), as well as implant removal, of course.  You can choose to have new implants placed, or you may choose to have no new implant placed, which would mean giving you back a smaller (perhaps saggy) breast.