Can I leave PIP Implants in ?

I am sorry to hear that you have PIP implants. It is recommended that you have these implants removed. The fact that there is a diagnosed rupture means that this should be done sooner than later. Treatment of the lymph nodes is slightly more controversial and you need to consult with a PS to go through the pros and cons of leaving / removing these. Aside the implants and lymph nodes the capsule needs to be addressed. Certainly in the ruptured side you may need the capsule and implant removed en bloc. This is more of an issue if you have little breast tissue but looking at your photos I feel that removing the capsule and the implants en bloc would be recommended. You can choose to remove the PIP's and capsules only and this is often a good option. If you choose to remove and replace you need to also consider a mastopexy. It is a very difficult decision and you need to consult with a PS to go through the pros and cons of all these options.