Breast Reconstruction/Silicone Impants?

I had mastectomy in 2004 and have silicone implants.MRI showed ruptured left implant sitting in the tissues created capsule.The implant feels firm,like a ball and not flat.I would appreciate if you could answer a few questions for me:1) Is the silicone leeking into my body now? What is the danger of silicone getting into the body? 2) Do I have to have a surgery right away? 3) What reconstruction options can you suggest, I'm 105 lbs/5 feet.Were there any advances in the implant world? Thanks!

Doctor Answers 3

Silicone Leak?

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I am sorry to hear about your problem but the good news is there are things that can be done to help you. To address your questions. The FDA has never proved that leaking silicone has caused any medical conditions in patients due to leaking silicone. Silicone implants were taken off of the market many years ago to research this problem because there were many lawsuits by people claiming that the leaking silicone was causing certain medical conditions. Silicone was NEVER taken off the market for breast reconstruction. Hmmmmmm. Why was that??? Most likely because we knew all along that silicone was not harming patients the way that patients were claiming they were but because these implants are so vital for a natural breast reconstruction we were allowed to continue using them for reconstruction but not for elective breast augmentation. Now the FDA has approved the use of them in both cosmetic and reconstructive patients. The only true danger is if the silicone leaks outside of the capsule then it can cause silicone to be extruded our of your skin over time. These are called silcone granulomas that can form in the breast tissue or skin. It is hard for me to tell you if you need surgery now or not, but I have many patients with reconstructed breast confined inside the capsule that wait many months if not years to proceed with removal. If it is hard and you hate the way it feels then maybe now is the time, but if you are ok with the way things look and feel then maybe you can wait. You can only make that informed decision with your surgeon. Usually in this situation I either remove the implant material with the capsule or the implant material alone and replace it with a new implant. Often times patients need some revisionary work as well. The latest and greatest in implant surgery is the following. We are on our 3rd generation implants with silicone that is much more cohesive and sticky. We are also about to see the release of the gummy bear implants here in the states very soon. These have been on trial and tested many many years ago by both major implant companies in the USA and now have finally just finished FDA approval. I think we will see them on the market very shortly here. These implants are literally like a gummy bear when you cut them in half. The do not ooze and leak all over. They are very cohesive. I am excited to try them. I got to use them in my residency training because we were part of the trial at my University. Good luck! I hope this helps.

Scottsdale Plastic Surgeon
5.0 out of 5 stars 54 reviews

Ruptured Silicone Gel Breast Implant...

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I'm sorry to hear about the complication you have experienced after breast reconstruction surgery.

It will be in your best interests to meet with a few well experienced board certified plastic surgeons who can demonstrate significant experience achieving nice results with breast reconstruction. In the meantime, you should have some peace of mind that the ruptured silicone gel  material does tend to remain in the breast implant capsule space.  It sounds like your body has produced a relatively thick capsule around the ruptured silicone gel implants causing the breasts to feel firmer/rounder (?compared to the other side).

Although not an emergency, removal/replacement surgery should be considered in the relatively near future.

 Best wishes.

Silicone rupture

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Usually and as you describe it the silicone remains within the capsule.  It may occasionally leak out of the capsule into local tissues. it is best to have it removed and replaced.  It should not migrate around the body.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

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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.