What are the risks/ outcome of removal of 30-year old RUPUTURED silicone implants - smoker, age 51 (intracapsular rupture detected in recent mammogram pain under axila)? Does it require 2 separate procedures, one for explantation, & capsulectomy, another for breast lift?
Risks, Expectations For Removal of 30-year Old Ruptured Silicone Implants Capsule (Intracapsular Rupture)? (photo)
Doctor Answers 4
Removing ruptured silicone implants
I routinely find myself removing old ruptured silicone implants. Mammograms are not good at detecting intracapsular ruptures. For that you would need an MRI scan but before you rush out to get one lets talk a minute. Chances are that your implants have been ruptured for years (perhaps decades). They need to be changed or removed so why bother with another expensive study that won't change what you are going to do anyway? It is possible that a tiny bit of silicone made its way to the lymph nodes in your axilla, but a vast majority of the silicone is still inside the scar tissue capsule around the implant. I remove both the capsule and the implant. There does not appear to be any large pocket of extracapsular silicone that needs to be addressed. Usually these cases go fairly well as the capsule is likely calcified and easy to dissect around. I can usually get almost all of the dissecting done before opening the capsule. I prepare for the silicone oozing out and catch it in a towel. A few more snips and the capsule is out, too. I scrub out the pockets before putting in new implants. If the implants are over the muscle I prefer not to do any lifting at the time of the capsulectomies especially since you are a smoker . You didn't say whether you want new implants or not. More information and a physical exam is needed to really give you options, but if you are worried about the implants being ruptured, don't be. Proceed calmly to your local board certified plastic surgeon to find out all your options. Most women are pleasantly surprised at how well things go and how much better their breasts look afterwards. Best of luck.
Removal of Ruptured Breast Implants and Breast Lifting?
Thank you for the question.
Removal of ruptured silicone gel breast implants generally is not an unusual or complicated procedure for most of plastic surgeons who do a lot of breast surgery.
What type of procedures you may benefit from after removal of the breast implants will depend on your physical examination and your goals. Sometimes patients choose to have breast implants replaced; sometimes not. Sometimes breast lifting is necessary to improve the shape and position of the breasts on the chest wall.
If so, it will be necessary for you just have stopped the use of nicotine for at least one month prior to surgery. One option that should be considered also is doing the procedure in 2 stages; the first stage would involve removal of breast implants/capsulectomy, the second stage would involve breast lifting.
In person consultation with well experienced board-certified plastic surgeons will be helpful; communicate your goals clearly with your plastic surgeon.
Each case is individualized based upon your desires and your anatomy. If you do not have a lot of breast tissue, you may want new implants +/- lift, or even just a lift or a delay of a lift until things settle down. An exam is key.
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Risk of removing a ruptured gel implant
If your implant is ruptured then it should be removed along with the capsule. This is usually not a complicated procedure but can have a risk of bleeding. Drains are frequently necessary.