I would recommend capsulectomy with removal of the implant material and likely a vertical mastopexy. If you desire to have fat grafting done, it can be performed at the same time but the volume provided with the fat would be more in the order of 200-250 cc for each side.
Explantation with lift
I would advise a total capsulectomy, lift (internal and or external or both), antifungals, immune and endocrine support, detoxification, and treatment of co infections. Fat transfer is best done in six months or longer when you have regained your health. You will also need removal of silicone laden axillary lymph nodes. Most doctors know very little about the chemical toxicity associated with defective silicone implants that occurs more often in patients with detoxification defects such as MTHFR and COMT. Our clinic has done more explantations and treated more women that any clinic in the world with these problems.
It seems you have extra-capsular silicone leak. This will require an MRI to assess the extent of silicone leak and the condition of the lymph nodes.Then an enblock removal of the implants with the capsule. Remove the silicone granulomas. six month later one can discuss all your options. You need to understand all the pros and cons of fat transfer to the breast and discuss all other options to achieve the results you desire. There is no scientific evidence of silicone detoxification works