Lump of Silicone (From Leaking Implant) As Diagnosed by Ultrasound, Should I Be Concerned About Losing Lymph Nodes?

I recently found a fairly large lump in my armpit(grape size). I had a dbl. mastectomy 5 years ago (no radiation, no chemo, no lymph node removal) and had breast reconstruction with silicone implants. They were not of the "cohesive gel" type. I met with a plastic surgeon experienced in reconstruction. He wants to replace with cohesive gel implants, but says it will be a complicated and messy job getting rid of the spilled silicone--am I likely to lose the lymph nodes? Losing some pectorals?

Doctor Answers 2

Silicone Gel Rupture

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Thank you for the question. Sorry to hear about  what you are going through.


Unfortunately, no one knows exactly what your surgeon will find in the axillary lymph node area. It may be that the  lymph node involvement is limited to the “lump” that you feel and that has been worked up with the ultrasound.  By the way, it may be that the pump you are feeling is a lymph  node  which has essentially been replaced by silicone material. I will attach a case example that you may find relevant  and helpful.  If the involvement is limited and the majority of these lymph nodes will be preserved.   Likewise, the pectoralis muscle should also be preserved.

I hope this helps.

Best wishes.

Removal of lump of silicone after breast reconstruction with gel implants

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Imaging studies can help determine before surgery if the lump represents the only silicone in the tissues. It is likely that a lump can be surgically removed without interfering with lymph nodes or other structures.

When an implant is leaking, the removal results in having to clean out a pocket that is filled with semi liquid gel.  Although this is messy, it is just a matter of perseverance and a lot of saline irrigation until the pocket is clean.

The pectoralis is most likely not t affected by the leaking implant since it is separated by the pocket lining. Your plastic surgeon should be able to give you the best information about the process of removing a leaking gel implant in your particular case,

Robert M. Lowen, MD
Mountain View Plastic Surgeon
5.0 out of 5 stars 54 reviews

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