My silicone implants are 40 years old. Is there a time when the silicone just hardens because it's old?

To specifically answer your question, NO, silicone does not harden, ever. But 40 year-old silicone implants had very thin shells, and despite the scan and X-rays, I suspect your implant shell ruptured, and the nodules you feel are free silicone granulomas with resultant tissue inflammation and scar fibrosis.An ER physician is totally unqualified to comment on your problem; you really need to see an ABPS-certified plastic surgeon for examination, evaluation, advice, and planning. This should be done promptly, as breast lumps (even if "pretty sure" they are implant-related) should never be ignored. But since the likelihood is that these lumps are indeed implant-rupture-related, you need a plastic surgeon.If indeed these lumps are implant-related, surgical repair is elective, and you can save for the required surgical costs. Insurance might cover implant removal, but not replacement or breast lift. Best wishes! Dr. Tholen

Dear AttillasTreasures,I understand your concern. However, without a proper assessment it would be difficult to determine what is wrong. It is best that you visit a board-certified plastic surgeon for further assessment. Only after thorough examination you can get proper recommendations and advice.Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Remember a sac or capsule of scar tissue forms around ALL breast implants and and holds silicone implants ruptured or not, contained inside. If patients take a hit or a fall to their chest, that capsule can tear or crack causing changes in some cases (hardening, leaking of the old type of silicone gel out of the capsule into the tissues, lumps, cellulitis etc) but if your ultrasound from the ER was normal then it sounds like your implants at least are intact. But a painless lump under the nipple should be evaluated in a non- ER setting, if you can!!!

I am sorry to hear about the problem you are experiencing.  Although definitive advice would require in-person evaluation, it is likely that you will benefit from removal of the breast implants as well as capsulectomy surgery. It is highly likely that the 40-year-old implants have ruptured.  If you choose to avoid surgery, I would suggest at least obtaining an MRI evaluation to rule out leakage. No need to go to the emergency room;  seek consultation with board-certified plastic surgeons in your area. Best wishes.

They were made with thin shells and less viscous gel that could bleed and permeate into your surrounding breast tissue so it would be recommended that you see a plastic surgeon and have your implants and scar tissue removed... and a re-augmentation done only if you really want to preserve your volume.  Your surgeon will be able to guide you through the decision process so you can make the best choice for yourself.

If it has been that long since you had your silicone implants placed, thee is a good chance that they are ruptured and you may want to consider replacing them. Mammograms will usually not be able to tell if there is a rupture.