CT Scan shows implant and capsular rupture with extracapsular extension of silicone. What needs to be done?

Question

Incidental finding: "Progress Notes: 2. CT Scan of Chest: ...Rupture of the right breast implant." "Chest Wall: There are bilateral rim calcified breast implants. There is implant & capsular rupture suspected on the right with extracapsular extension of silicone." "Conclusion: Incidentally noted right sided extracapsular implant rupture with extracapsular extravasation of silicone." MD says no treatment needed. Implants approx. 35 years old. I am 66 & in reasonably good health. What to do?

Douglas J. Mackenzie, MD · Answer

Thank you for providing the exact quote from the radiologist's report.  I'm not sure who "MD" is, though I would assume it is your primary care provider.  You said this was an incidental finding, so presumably you had another reason to get a chest CT scan, which may impact your care.  The bottom line is, you need to see a plastic surgeon.  When I see someone come to me with old implants, and not only a documented implant rupture, but documented extracapsular extravasation (outside of the capsule and into the surrounding breast and subcutaneous tissue) of silicone, I recommend capsulectomy.  This is really a no-brainer.  Capsulectomy removes the breast capsule (often calcified as in your case), and the ruptured implant within it.  I also try and remove extracapsular silicone, but sometimes it is impossible to remove it all (one of the reasons to not wait on ruptured implants, monitor implants, and consider prophylactically changing implants far sooner than 35 years).  It will be your choice whether to replace the implants or not.

Asif Pirani, MD, FRCS(C) · Answer

You need to see a BC PS.  If you were my patient, I would recommend removing the implants and silicone.  It is up to you whether you replace the implants or not.Best,

Jourdan Gottlieb, MD · Answer

Physicians don't treat xrays and scans--we treat patients. There is nothing in this question that identifies any clinical problem, and it sounds like this was a chance finding on a study done for another reason. I further cannot tell what kind of MD gave the advice that no treatment is needed. Although that may be good counsel, it would have more validity if it came from a plastic surgery than from a radiologist or primary physician.If you haven't already done so, see a plastic surgeon. If you have and are uncomfortable with the advice, seek a second opinion.Best wishes, Dr Gottlieb

Frederic H. Corbin, MD (license restricted) · Answer

If you were my wife or mother and assuming they were in good health, I would recommend removing the old implants and capsules and extravasation of silicone.  It would then be their choice if they wanted to replace with new implants.

Dr. Corbin

CT Scan shows implant and capsular rupture with extracapsular extension of silicone. What needs to be done?

Answers (4)

Answer: Ruptured implant

Answer: Ruptured implant

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CT Scan shows implant and capsular rupture with extracapsular extension of silicone. What needs to be done?

Answers (4)

Answer: Ruptured implant

Answer: Ruptured implant

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Everything you need to know about Breast Augmentation

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