35yo submuscle explant - is there a chance I could have no issues if they are left untreated?

Ruptured implants need to be removed but the capsules do not necessarily have to be removed with them. Your implants seem quite small and it should be a straight forward operation.

Best Wishes,

Gary Horndeski, M.D.

If your implants were placed before 1992, they are leaking and need to be removed. If they were placed after 1999, then you have the cohesive gel, and the implants could just be removed. En bloc surgery is for cancer surgery only and not elective breast implant and capsule removal. If your capsules are thin, they could be left in place, especially if you have smooth implants.

Thank you for sharing your question. There are a lot of decisions that need to be made in order to perform the best operation for each patient. If you are having no issues physically I would recommend removing the ruptured implants and/or replacing them based on your desires. Depending on length that implants have been in place, and possible changes to the capsule as a result either a subtotal or total capsulectomy could be performed and may be necessary (thickened/calcifications). I would not leave your breasts as they are due to secondary deformities and pain from the ruptured implants poking your skin.