After my implants are explanted, do I need to take a test to make sure that all the silicone was removed?

Question

I’m in the process of getting my silicone breast implants removed. Both of them have ruptured o intracapsular and the other is a extrcapsular. I’m just going to have them removed and nothing else put in so my question is after I have them explanted should I have a certain test or tests to make sure that all the silicone has been removed?

Martin Jugenburg, MD · Answer

Hello, thank you for your question. I personally have not heard of a test? Typically in the operating room, the surgeon will wash out the pocket and see inside. Speak to your plastic surgeon to see what will be done. Best of luck!

Alan Gonzalez, MD, FACS · Answer

Hello @SavingGrace60, thank you for your question. Following removal of ruptured silicone breast implants, there isn't a specific test that can definitively confirm that every trace of silicone has been removed. During breast implant removal, the fibrous capsule that forms naturally around the implant must be completely excised (a procedure known as a total capsulectomy). This procedure takes skill, knowledge and experience from the surgeon performing the procedure.  Best wishes! Alan Gonzalez MD, FACS.  American Society of Plastic Surgery Member (ASPS), International Federation for Adipose Therapeutics and Science Member (IFATS),Colombian Society of Plastic Surgery member (SCCP).

Finny George, MD · Answer

Hi, thank you for sharing your question. After implant removal, while imaging studies may be able to detect abnormalities related to silicone, there is no specific test to see if all of it was removed from your body.

Fernando Ovalle Jr., MD · Answer

Hello and thank you for your question.

Currently there is no medically accepted labwork to ascertain that "all of the silicone has been removed." During the explantation, the surgeon typically visually inspects the breast pocket and repeatedly cleans the tissues with sterile saline/antibiotic irrigation. IV antibiotics are typically given prior to the start of surgery, and sometimes after surgery. The majority of patient heal without any issues, but, as with any surgery, there are still risks, such as bleeding, infection, wound healing problems, and collections of fluid. Surgeons work to minimize these risks as much as possible. I encourage you to have an in-person consultation with a board certified plastic surgeon to discuss your particular history and anatomy details and further answer your questions and concerns!

Kevin Brenner, MD, FACS · Answer

SavingGrace60: Ultimately, it is the responsibility of the surgeon to remove any remnants of silicone...especially when silicone implants are ruptured. Free silicone can and does react with the capsule scar tissue surrounding the implants, so it is very important in these situations to remove all of the capsule tissue...and send that for pathology. Apart from that, there is no actual testing for silicone.

Andrew Bonett, MD · Answer

That is a great question. As you probably already know, MRI or ultrasound can detect a ruptured silicone gel implant. However, after the implant and all contents within the pocket have been removed, or explanted, there is no other imaging required. Your surgeon will be able to see all the silicone and make sure it is all removed. If there was a very small amount left behind, it would likely be too small to even be picked up by the test. The good news is that a very small amount would also not pose any health risks, so there is really no need to worry about it after it's all removed. It is possible to find silicone in the lymph nodes, but this usually only happens when a ruptured implant is ignored for a very long time.

David Rankin, MD · Answer

The most important thing is to go to a Doctor with experience in doing explant surgery. The intracapsular rupture side can be visualized during surgery to see if all silicone is removed. However, when there is a severe extracapsular rupture sometimes the silicone can migrate into breast tissue itself. An MRI can often confirm this and this would be the best study to get after surgery if you wanted to check for silicone in the tissues.

Ira H. Rex III, MD · Answer

There are no good tests to indicate whether ALL of the silicone has been removed. Your plastic surgeon has the best opportunity at the removal operation to determine the extent of removal of silicone, although microscopic areas might not be identified.

Shaher W. Khan, MD · Answer

Hello, thank you for your question! Unfortunately, there is no specific blood panel or test to look for complete removal of capsule and breast implant (saline & silicone). The ultimate way is to see what the post operative recovery is like, with freedom from breast implant illness symptoms. There is no imaging test to confirm this either. The goal of the surgery is to remove the entire implant, capsule, and all inflamed tissue, sincerely.

Vishnu Rumalla, MD · Answer

Thanks for your inquiry,  in terms of a particular test-a routine mammogram may visualize free silicone as well as an ultrasound directed at a specific area.  Hope that helps, best of luck.

After my implants are explanted, do I need to take a test to make sure that all the silicone was removed?

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