I have had my implants in for 20 years they have been replaced twice they are dimply and lots of scar tissue?
Best to be seen for an exam to determine the course of action. Based on the information shared, I would remove the implants and capsule, and replace with new ones if your desired.
You would have to be seen in person but it sounds like you might have rippling and a capsule issue. Best of luck.
Capsulectomy with remove replace
It would be best to remove the capsule in its entirety. Then, the space can be modified going mm by mm seeing what has been done and what needs to be fixed. After the new pocket is created, a new implant should be placed in the space. This needs to be done by someone who has vast experience in this area. Revision surgery requires drains because the fluid is going to be generated when you operate on the scar capsule. If you provide a mechanism for the fluid to be removed (i.e. drains), the risks are lower. If the fluid accumulates because there were no drains, it will most certainly cause problems in the future.