Best procedure to be taken to exchange ruptured silicone implant and revise on asymmetric breasts? (Photo)

This is a follow up on my last post to which I want to add some pictures. My right breast is seriously swollen as result of a ruptured implant and lots of fluids around it. My left breast is saggy and asymmetric especially in the cleavage area. Further I would like to achieve a slightly smaller size. Presently D, my maximum wish was C. But as the implants were supposed to fill the empty breast tissue they ended up bigger.

Doctor Answers 4

Exchanging Ruptured Silicone Implanst and Correcting Asymmetrical Breasts

 A #rupture or #deflation of a breast implant may be experienced at any point after the initial augmentation; this complication may be increased by an under-filling or overfilling of saline solution into the implant, excessive compression, trauma, and other causes. (If the implant shell if not filled with the correct amount of saline, there may be a crease or fold in the shell which often leads to a rupture).  The patient will be able to self diagnose the need for an implant exchange (if using a saline implant) because if the current implant ruptures, the breast will shrink to approximately its preoperative size. A silicone implant that has a rupture is usually noted on a routine mammogram or MRI scan. In either case although the situation needs to be corrected on a timely basis, it is not dangerous to your health from our current knowledge base. Silicone implants after 2006 are more cohesive and less likely to leak. 

When the patient has significant symptoms, complete or partial leakage of their saline implant, or concerns regarding silicone leakage, it is recommended that the implant is removed and exchanged. Frequently, this is performed on both sides depending upon the age of the implant. Capsulotomy or opening up of the capsule may be required or frequently capsulectomy, which is removal of the scarred capsule, is recommended to ensure adequate pocket dimensions. New implants may then be placed in the same existing position or may undergo a change of placement frequently from submammary to subpectoral position and, on occasion, the other way around.

However, any #asymmetries regarding the folds under the breasts may not be totally corrected. To better determine the technique and placement best for your revision, I suggest you see your  board-certified surgeon to discuss in more detail.


Orange County Plastic Surgeon
5.0 out of 5 stars 107 reviews

Ruptured implant breast lift exchange question

Hello and thank you for the question and the photos. A ruptured implant is a risk of surgery and thankfully, here in the US, all FDA approved implants have a warranty coverage. 

I would suggest the following plan: 

1. take both implants out. Allow the breasts to heal and return to a non swollen size. 

2. go back later ( several months later)  and do an exchange to smaller silicone implants and correct the breast shape and sagging with a FULL mastopexy or breast lift. Your photo shows a periareolar donut lift. I am not a fan of the donut lift as it often leaves a wide unnaturally large areola that is flat and stretched out. A full lift will help with this to remove the loose skin, reshape the breast and make the areola smaller. 

As you have experienced, larger implants are not a substitute for a breast lift. I realize that no one wants the added scars,  but is necessary to correct the breast sagging. There are always tradeoffs to every decision you make.

You should seek several consultations with board-certified plastic surgeons in your area before making any decisions.

As always it is best to be healthy, no smoking, and to make sure any health care concerns you have are managed by your primary care physician.

Best to you

Bennett Yang, MD
Rockville Plastic Surgeon
4.8 out of 5 stars 21 reviews

Removal

You could consider exchanging both implants for smaller ones, and lifting the sagging side. I would suggest meeting with a board certified plastic surgeon and discussing all your options.

Connie Hiers, MD
San Antonio Plastic Surgeon
4.6 out of 5 stars 13 reviews

Correction of large implants, rupture implant and asymmetry

Thank you for asking about your breast implant revision.

  • I am sorry to hear about these problems.
  • This is what I would probably recommend: 
  • remove the implants and the capsule en bloc if possible,
  • lift the smaller breast, lift and 
  • reduce slightly the larger breast and release the breast tightness in the lower part of the breast
  • place implants approximately 25% smaller than the ones you now have.

Always see a Board Certified Plastic Surgeon. Best wishes  - Elizabeth Morgan MD PHD FACS

Elizabeth Morgan, MD, PhD
Atlanta Plastic Surgeon
4.6 out of 5 stars 43 reviews

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.