Need rec for experienced, reputable doctor to remove leaky silicone implants using en bloc technique w/ fat transfer & lift

Have meme silicone implants put in Dec 1990. ultrasound showed leakage bilaterally into axilla. Don't want them replaced. Realize research has not definitively shown a connection b/w implant rupture and joint pain or other problems, I have unexplained joint pain, insomnia, sharp burning pain and significant memory problems for the past 6-7 yrs. I want them removed and leaked silicone completely removed. Won't be happy w/ the way breasts will look w/only removal. Want mastopexy & fat transfer
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Doctor Answers 9

Removal of silicone implants using en bloc technique

To be an expert in any procedure, you have to have done a lot of these procedures and have published papers in the area of expertise.

The capsule (scar tissue) is your body's response to your implants. It may contain silicone gel, silicone shell fragments, bacteria, calcification, and inflammatory cells which have been mobilized by your immune system to react to different components of the implant. Research has shown that the capsule does not disappear on its own when only the implant has been removed (see Nancy Hardt's paper in Plastic and Reconstructive Surgery.) In addition, if you have pain around the implants, it is usually due to the pulling effect of the scar on surrounding muscle and tissue. If you have health problems that could be from the presence of the implants, removal of the capsule is critical in improving your health.

Linked are my research studies and my en bloc video.


Cleveland Plastic Surgeon
4.5 out of 5 stars 84 reviews

En bloc technique removal of breast implants...

I would suggest starting with the American Society of Plastic Surgery and/or the Aesthetic Society of Plastic Surgery to obtain a list of well experienced board-certified plastic surgeons. Then, I would suggest you visit a few surgeons whose practices concentrate on aesthetic surgery. Ask to SEE lots of examples of their work AND preferably speak/see patients who have had similar procedures done.


Be very careful with your decision-making. You will find, while doing your due diligence, that there are many different “specialties” who will offer their services to you; again, I strongly recommend you concentrate on surgeons certified by the American Board of Plastic Surgery.


Generally speaking (in my opinion), unless the breast implant capsules have thickened (and/or are otherwise symptomatic), are associated with the ruptured silicone gel breast implants, or if the patient has concerns about "medical conditions" related to the breast implants, capsulectomy is not universally necessary. For these patients, en block removal of breast implants is a good procedure.


On the contrary, capsulectomy can expose patients to additional risks, such as bleeding, size loss, contour irregularities and other serious complications. In other words, any maneuver performed during surgery exposes patients to additional risk (morbidity). For example, attempting to remove very thin capsule densely adherent to the patient's rib cage may expose the patient to significant bleeding and/or entrance into the thoracic cavity.

You may find the attached link, dedicated to breast implant removal surgery concerns, helpful to you as you learn more. Best wishes.

Leaking silicone implants need to be removed

I would agree, all silicone, capsule and leaking silicone needs to be removed.  I would wait at least 6 weeks and then re-evaluate if any other procedure needs to be performed later.

Good Luck!

David Finkle, MD
Omaha Plastic Surgeon
4.9 out of 5 stars 73 reviews

Implants

Thank you for your question.  You should begin your search by looking for a doctor in your area that is board certified in plastic surgery and is an expert in implant removal/breast lift.  Focus primarily on the before and after photos as well as patient reviews to determine who is the right surgeon for you.

All the best,

Dr. Results
Miami, FL

#Explant #BreastImplantRemoval - experienced, reputable doctor to remove leaky silicone implants

You should start with board-certified plastic surgeons near you.  You can find them at surgery.org and plasticsurgery.org, or via the ASPS and ASAPS.  You'll need to make a few phone calls to get a sense of which doctors near you are comfortable with this.  You may need to travel to the St. Louis or Kansas City metropolitan areas in order to find surgeons with enough experience.

The first step is to try to assess how much leakage there is.  Ultrasound is good; adding an MRI can provide additional information.  Then you have to discuss the removal of the silicone.  It is possible that the removal of the silicone would be such a mutilating procedure that it is not recommended to do so; i.e., that going after every last bit of silicone would mandate a procedure that may not be warranted for you.  I agree with trying to remove as much of the capsule as is, again, practical.

Then you'll face the issue of rebuilding your breasts.  Doing a lift and fat transfer at the same time as your removal sounds like too much to do at once.  The removal alone may be a fairly extensive procedure; adding even the lift may compromise the blood flow to your nipples and areaolas.

This is where you'll have to do your research and follow the guidance of whichever surgeon you choose.  You will like face a staged procedure, and you should find out what's involved with each aspect of what your surgeon recommends.  You may, for example, not even need a lift.

There is a lot to research in your situation and you are right to do it methodically.  You may need to meet with 5-6 surgeons before you find one you're comfortable with.

I hope that this helps and good luck,

Dr. Alan Engler
Member of #RealSelf100
@RealSelf

Removal

Your implants are of the age that they do need to be removed along with the capsule. Your medical problems are probably not related to your implants. You might need to speak with your medical physician and see if you are a candidate for surgery right now. If you are, please find a board certified plastic surgeon in your area. Your implants can be removed. I would not do the lift and fat transfer at the same time, and possibly, neither at the time of removal. What can be done in the first surgery will be discussed during your consultation..

Connie Hiers, MD
San Antonio Plastic Surgeon
4.6 out of 5 stars 13 reviews

Meme Breast Implant

Meme breast Implants are covered by polyurethane shell. the polyurethane disintegrates with time and what is left is the remnant of a shell and silicone thin gel. These implants were used in the 80sand  90s.Removed from the market in 1991. Not in use in the U.S. any more. the implant polyurethane does not have a good capsule formation, but attempt to do an en-block removal is important, may not be possible, because there is no capsule.
 The pocket needs to be irrigated with wound detergent to try to remove all the silicone gel. based on my experience with removing the Meme implants one finds these implants without any polyurethane coating, but a free silicone gel. Removal require a larger inframammary incision and careful gentle removal of the remnant of the implant. because of the byproduct of polyurethane disintegration, it is recommended to remove all Meme implants.

Good evaluation of the axilla is needed, MRI of the breast including the axilla, How many nodes contain silicone, and where in the axilla are these lymph nodes. Debulking of these lymph nodes if they are low in the axilla.

Samir Shureih, MD
Baltimore Plastic Surgeon
4.2 out of 5 stars 7 reviews

Need rec for experienced, reputable doctor to remove leaky silicone implants using en bloc technique w/ fat transfer & lift

Thank you for your question and I am sorry to hear about your problematic symptoms.  I would recommend you visit the link below.  This site will locate board certified plastic surgeons in your area.  You can then better research the right physician for you.  

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 43 reviews

Explantation

To recover you will need en bloc total Capsulectomy, immune and endocrine support, antifungals and detoxification of silicone chemicals and biotoxins.  

Susan Kolb, MD
Atlanta Plastic Surgeon
4.7 out of 5 stars 23 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.