I fell hitting my breast hard and 3 months worried about rupture. I have had silicone implants for 38 years. Advice?

Thank you for your questions. If you are concerned about the implants, then an MRI would be the study of choice. Although other imaging studies can offer information about implants, the MRI is best to evaluate the implants for signs of rupture or other problems. You might be able to obtain this from your regular doctor. Once you get the MRI results, then go see a local plastic surgeon who is board certified by the American Board of Plastic Surgery to discuss your results and options. Hope this helps!

Dear sherrywalker,it is hard to tell for sure without an examination. I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

should be replaced or removed as those implants 'bled' where particles of silicone could leak through the shell and penetrate the adjacent breast tissue.  They are the 'bad' implants and the newer ones are cohesive and do not do that.  In addition, most people with implants your age have all kinds of other problems including contractures, calcified capsules, ruptured implants, etc so schedule a consultation with a local plastic surgeon and get them out.  You can choose to replace them or have a lift if indicated but I would tell all my family members who have old gel implants to get them out asap.

It is impossible to know if your implants are broken without a good physical exam and an MRI.  However, if your implants are 38 years old it is probably time for a replacement or removal.  Almost all of the implants I see that are that old are long since ruptured and have hard capsular contractures.  Seek out a Board Certified Plastic Surgeon that specializes in breast surgery for a consultation.

Go see a board certified plastic surgeon.  We now follow-up silicone implants as per FDA guidelines with periodic MRIs.  However, with very old silicone implants (and evidence of leaking on a mammogram), I advise my patients to get them removed and replaced (or not replaced, as desired).  It is common to see leaking of those old implants even when it wasn't expected ("normal" mammogram).  Implants as old as yours are commonly ruptured (leaking) even without having had any significant trauma.  The silicone in those old implants is a mix of polymer size, unlike the ones nowadays that have more uniform longer chain silicone polymers.  That old gel is a sticky goo unlike the cohesive, "jello" or "gummy bear" consistency now.  If the silicone from your leaking implant gets outside the capsule ("extracapsular"), it can create lumps (granulomas), migrate to your armpit lymph nodes, and is often impossible to completely remove.  Implants are NOT forever.  There will come a time when you need to have them changed out.  That time will be long before 38 years.