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

Question

Tks to Drs Barrett, Castillo & Gonzalez for reponses. Bilateral intracap ruptures, no issues physically, great shape, 65yrs old. I am more scared of an attempted en bloc than leaving them untreated. We have 2 PS in Thunder Bay, 1 refused my surgery -waiting on referral from other who I am hoping will just remove silicone, flush, and close me. Implants are 125cc and 75cc? Is there a chance I could have no issues if they are left untreated?? any info, studies, (other than Danish 1)

Gary M. Horndeski, MD · Answer

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.

Nelson Castillo, MD · Answer

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.

Daniel Barrett, MD · Answer

Dear Polite306419,
in case of implant rupture, it is recommended to remove implants in order to avoid possible complications. If you are considering a surgery, 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

Connie Hiers, MD, FACS · Answer

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.

Douglas Taranow, DO, FACOS · Answer

I feel any surgical approach is viable.  Whether an en bloc total capsulectomy with explantation vs explantation with capsular clean out.
You are asymptomatic and have no idea how long the ruptures have been present.  A clean out removes the majority of the free silicone, however, residual silicone always remains.  Possibly not an issue as no medical effects exist to date.  
You may decide to replace them at the same time as the clean out procedure. 
Best wishes.
Dr. Taranow

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

Answers (5)