50 years old, ruptured silicone implant. What are my beset options?

Question

Seeking advice about what options would be best for me. I had saline filled implants that were removed because of a rupture 10 years ago. Replaced with silicone implants that now one has ruptured and needs to be removed .. Has caused a lump near clavicle. I am 50 years old and want what is best for my health. What do you recommend?

Harry T. Haramis, MD, FACS · Answer

The implants can be removed completely or easily changed for new ones.

An exam with your/a plastic surgeon is recommended to further discuss as well as to determine the lump- if it is implant, scar tissue to be addressed as well.

Rupture is not usually an emergency and can be dealt with conveniently.

Muge Sevindik, MD · Answer

The safest option for your health at this stage would be to remove the ruptured implant, clean out the existing capsule and any silicone residue, and allow at least 3–6 months for healing.
After this period, another breast surgery can be planned.
However, for your safety and the best long-term outcome, we strongly recommend waiting before placing new implants.

Emre Guvercin, MD, FEBOPRAS · Answer

At age 50, with a second implant rupture and a new lump near your clavicle, I would prioritize a thorough evaluation before deciding whether to replace your implants.
The lump could be related to silicone migration into a lymph node, but this cannot be assumed without examination and imaging. I would recommend breast and regional lymph-node ultrasound, appropriate breast imaging, and MRI when needed to assess the extent of silicone rupture. Any suspicious lump should be investigated independently rather than automatically attributed to the implant.
If rupture is confirmed, I would recommend removal of the damaged implant and accessible free silicone. Capsulectomy should be individualized according to the capsule's condition, silicone contamination, and other findings rather than performed automatically in every case.
If your priority is avoiding further implant-related problems, explantation without replacement is a reasonable option. A tissue-preserving Push-Up Lift may help reshape your remaining natural breast tissue and restore a more attractive contour without requiring new implants.
The most important first step is to establish the nature of the clavicular lump and the extent of the rupture before planning surgery.

Mert Demirel, MD · Answer

A lump near the collarbone after a silicone rupture should be evaluated before any surgical plan is made. When silicone escapes the shell, it can travel to the lymph nodes in the armpit or above the collarbone, and that is usually the cause of a lump in this area. This is generally not dangerous in itself, but it needs to be confirmed, and other causes unrelated to the implant need to be ruled out.
The first step is an MRI or a high-resolution ultrasound. Imaging shows whether the rupture is contained within the capsule or has spread beyond it, and what the lump actually is. If needed, the radiologist can sample the lymph node.
Once that is clear, the options are fairly straightforward. The ruptured implant should be removed, usually together with the surrounding capsule, so the free silicone comes out with it. After that there are three paths: replacing both implants, removal with a lift, or removal without replacement. At 50, after two rounds of implant problems, it is reasonable to seriously consider living without implants; many women are happier than they expected after removal, especially when it is combined with a lift. Silicone in a lymph node usually does not need to be removed unless it causes symptoms or the diagnosis is uncertain.
The right path for your health depends on the imaging, the quality of your tissue, and how you feel about having implants again.
Before deciding, ask your surgeon whether the rupture is intracapsular or extracapsular, whether they plan to remove the capsule, what the imaging shows the lump to be, and what you can realistically expect with and without new implants.

Yasemin Aydinli, MD · Answer

A ruptured silicone implant needs to be removed, and the lump you feel near the collarbone should be examined before surgery. When silicone leaks outside the implant it can travel to the lymph nodes and form a hard lump, so an ultrasound and an MRI are the right first step, to see how much silicone has left the implant and whether it has reached the tissue around the breast or the armpit. Since you have had implants for many years and this is your second set, I would also remove the implant on the other side, together with the scar capsule around both, and not only the ruptured one. The capsule is removed so that any leaked silicone is taken out with it, and this is more complete than removing the implant alone. After that you can choose between staying without implants, which often leaves loose skin that may need a lift, or placing new implants with a lift at the same operation. Your skin has been stretched twice, so a lift is usually part of getting a good shape. Leaked silicone cannot always be removed completely if it has spread into the lymph nodes, and this is something to check on the scan before deciding.

Mehmet Ozdemir, MD · Answer

Without photos, we cannot assess your breast condition or determine the most appropriate surgical option. Please provide clear photos for evaluation.

50 years old, ruptured silicone implant. What are my beset options?

Answers (6)

More Breast Implant Revision Questions

Breast Revision After Implant Removal: Implants Alone or With a Lift? (Photo)

Is it possible to create more lateral fullness/side boob during the revision while keeping my current 415cc implants? (Photos)

Implant revision options after significant weight loss - is a lift necessary? (Photos)

67 years old. Implants since 1987, capsular contracture. Can I replace the implants without a lift? (Photos)

230 cc Demi profile implants by Motiva placed over the muscle - Breast implant exchange or pocket revision? (Photos)

Breast Implant removal & replacement - is this possible at 69 years old after one implant collapsed?

WE SEND PRETTY
EMAILS