Hi. Based on your photos, your case is certainly not straight forward and I would caution you to really research. First, since they are silicone placed in 1985, I can guarantee you that they will be ruptured. You will have free silicone within the pocket and in the capsule. The capsule is that envelope of scar tissue that all patients with implants develop post- op. In addition, the fact that they are hard represents that you've formed a class IV capsular contracture. Additionally, they are droopy or ptotic and will require a lift.To summarize, you will need removal of the implants with all implant material . Additionally you will need bilateral capsulectomies to remove all existing internal scar tissue containing some of the free silicone. Then you will need to have a breast lift with an implant exchange to the new silicone gels. The combination of these procedures may place your breasts at risk for healing. The procedures may be performed at the same time but it may be best to stage them to be on the safe side. You need to seek out a surgeon well experienced in secondary and tertiary cosmetic breast surgery problems and repairs. You are probably looking at close to $ $10,000.Word of warning......research lots and lots. I am certified by the American Board of Plastic Surgery and have practiced in the"land of breast implants", Miami, for the past 29 years. I encourage you to look up the surgeon you eventually select and make sure they have years of experience in performing cosmetic breast surgery. Furthermore request to see before and after photos of previous patients by that doctor....not a clinic or surgery center. Do your homework......research and verify the doctor's credentials. Have they had problems with the Board of Medicine, disciplinary or otherwise. Any law suits?How about the center, clinic or facility? Are they accredited by a national organization or do they just have State approval. Understand that at the current time, there are three nationally recognized organizations responsible for the highest levels of patient safety, AAAASF, AAACH and JCHO. You owe it to yourself to position yourself for the best possible results but under the most stringent safety regulations, If you have kids, even more so.How about anesthesia? Will you have a medical doctor certified by the American Board of Anesthsiology or a certified nurse anesthetist (CRNA)? Understand that there is no substitute for research. Cosmetic surgery, no matter how simple it may be to the patients, are invasive procedures and as such carry certain risks and complications.I wish you the best on your journey. I hope that the info provided has been helpful. Should you require any further clarification, do not hesitate to contact our institute. I answer all questions personally, not through patient coordinators or other marketing individuals.In our office we use TouchMD which is a web based program in which patients have the ability to load their picture unto the program. I then evaluate them and can actually draw on the picture to show a potential patient where the incisions would be located and how the procedure is to be realized. It's all done to comply with HIPPA which is the federal law that protects the patient's medical information. Look them up. Good luck Dr PG
