Does an Implant Always Have to Be Removed if There is Calcification?

Doctor Answers 11

Best to Remove Implants with Calcification

Heterotopic Calcification refers to calcium present at an abnormal site such as around your breast implant in the capsule. Calcification means calcium (an egg shell is mostly calcium for example) not bone in which calcium is but one ingredient. Heterotopic calcification is not an unusual finding in implants over 15 or more years. It can be found with saline or silicone implants thought in my experience more common with silicone implants that have ruptured or the older ones that have "silicone bleed" - that is the implant membrane is intact but there is still some sticky silicone on the outer shell. It is not related with any disease process and cannot harm you though can feel uncomfortable as part of a capsular contracture, makes your implant feel hard, and your breast can be  distorted by its presence. If the radiologist feels certain it does not look like a malignancy, that your implant has not ruptured  and its presence does not obscure reading mammograms then you theoretically can leave it alone. However my recommendation would be to remove it as it is an abnormal process that makes your breast feel hard and causes distortion

Orange County Plastic Surgeon
4.9 out of 5 stars 157 reviews

Removing breast implants

As long as an MRI and mammogram shows no evidence of rupture or malignancy, then you'll probably be okay leaving in the implants.  Make sure you're cleared by an oncologic breast surgeon as well.

Jeffrey E. Schreiber, MD, FACS
Baltimore Plastic Surgeon
5.0 out of 5 stars 202 reviews

Remove Calcification of the Capsule

If there is implant capsule calcification, it should be removed so as not to interfere with interpretation of mammograms.

Capsule calcification is almost always a sign of silicone gel implant rupture, so removal of implants with capsulectomy should be performed.

You may choose to leave the implants out or to replace them.

Paul C. Zwiebel, MD
Denver Plastic Surgeon
4.7 out of 5 stars 41 reviews

Concerned about Capsular Contracture

One of the most common problems is breast capsular #contracture or the development of thickening, and contracture of the capsule that exists around the breast implants. Severe capsule contracture probably occurs in less than 15% of augmentation patients. Every woman has a breast capsule around their implant and this is a normal phenomenon. The capsule itself could be as thin as Saran Wrap but may also become calcified and thickened. As it thickens and shrinks, the patient may develop a feeling a firmness of the breasts and in its worst situation, the breast may become painful and abnormal in appearance, achieving a very round, hard, and uneven appearance. There may be distortion and possible breakage and leakage of an older implant, but may also include a newer #implant. Nicotine users, such as smokers, have up to a 30x increased risk of #capsular contracture.Saline implants may deflate spontaneously. 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 of the capsule may be required or frequently capsulectomy, which is removal of the scarred capsule, is r#ecommended 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.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 110 reviews

Calcified capsules should probably be addresses, call your PS.

The vast majority of calcified capsular contractures are associated with silicone implant bleed or ruptured silicone implants. Under these circumstances, it’s probably reasonable to change implants and remove the capsule with its calcifications.

It’s important to realize that health problems have not been associated with calcified capsules.For this reason, it’s not an absolute necessity that they be removed.Unfortunately, they may obscure the detection of breast cancer during mammography.In addition, they can adversely impact the patient’s aesthetic result.Calcified capsules are often associated with breast pain, breast distortion, and breast hardening.

Although calcified capsules don’t have to be removed, in most cases it’s appropriate to perform an implant exchange with bilateral capsulectomy procedures.Under these circumstances, the clinical results are excellent and levels of patient satisfaction are high.

If you have calcified capsular contractures, it’s important to consult a board certified plastic surgeon.This surgeon can evaluate your capsular contractures and formulate a treatment plan that not only addresses your anatomic findings but achieves your aesthetic goals as well.

Richard J. Bruneteau, MD
Omaha Plastic Surgeon
4.9 out of 5 stars 194 reviews

Breast Implants and Calcification?

Breast implants associated with calcification do not necessarily have to be removed.  Each patient's situation should be evaluated individually/specifically. For example, if a patient has a strong  family history of  breast cancer,  then removal of the breast implants/ calcifications may be indicated to avoid  radiographic confusion  and/or delay of diagnosis of breast cancer.

If patients with calcification choose to have the breast implants left in place however close radiologic  follow-up will be important.  For example, any change in the nature of the calcifications may require  further evaluation  and/or biopsy.

I hope this helps.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,499 reviews

Calcification in the capsule means implant leak

When the silicone gel bleeds and leaks onto the capsule, irritation and inflammation causes the capsule to calcify, a sure sign that the implants is no longer intact and suffers an intracapsular leak. Both implants and capsules should be removed to prevent further capsular contracture.

Best of luck,


Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 43 reviews

Calcification and implants

If your implants are okay and there is no suspicious radiologic findings with the calcifications and they are considered benign, then they probably do not have to come out.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Calcification of the breast tissue

As has been mentioned, the location of the calcification is the more important consideration. If you have older implants and there is calcification around the capsule that is not concerning to the radiologist for malignancy, there is no rush to have surgery. If this is the case though it is often associated with firmness of the capsule making your breast(s) harder. It would be prudent to have these implant and associated capsules removed and replaced with new implants in the near future. If the calcifications are in the breast tissue you will need to discuss these results with your doctor who ordered the exam for you.

I hope this helps

Dr Edwards

Michael C. Edwards, MD, FACS
Las Vegas Plastic Surgeon
5.0 out of 5 stars 35 reviews

Calcification does NOT mean automatic Breast Implant Removal

Calcifications are not seen with the breast implants but may be seen in advanced cases of severe scarring of the scar capsule normally found around breast implants. In some women, especially old silicone gel implants which have leaked, the body reacted in a very exaggerated fashion forming very thick dense scar tissue with calcifications which in some cases resemble oyster shells.

Calcification is NOT an automatic reason to remove the breast implants UNLESS the IDENTITY of the calcification cannot be established and they could be thereby hiding a malignancy. Modern MRI techniques can read a lot of breast which were hard to be inspected years ago but the test runs over 2,000 dollars. It is therefore up to you and your surgeon to decide what would be best.

Dr. Peter Aldea

Peter A. Aldea, MD
Memphis Plastic Surgeon
4.9 out of 5 stars 109 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.