26 years ago, I had Bilateral mastectomy with implants. Implants have ruptured. Can new implants be inserted at time of removal?

I am scheduled for surgery. The doctor says that I have to wait 6 months to allow my body to heal and then come back for another surgery to get new silicone implants. My MRI showed no leakage outside the capsule. I would like to have this all done in one procedure. I am 62 and in good health, active, and on no medicines.

Doctor Answers 10

Replacement of Ruptured Silicone Implants after Mastectomy

In principle, it should be possible to replace the old ruptured silicone implants at the time of removal. It is advantageous that the rupture is intracapsular, but sometimes a capsulectomy might have to be performed which might thin the breast tissue further. Placement of a dermal matrix might be helpful to provide support of the new implant. Consider getting a second opinion from a Board Certified plastic surgeon with experience in reconstructive breast surgery.  

Replacement of Ruptured Silicone Implants after Mastectomy

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
In principle, it should be possible to replace the old ruptured silicone implants at the time of removal. It is advantageous that the rupture is intracapsular, but sometimes a capsulectomy might have to be performed which might thin the breast tissue further. Placement of a dermal matrix might be helpful to provide support of the new implant. Consider getting a second opinion from a Board Certified plastic surgeon with experience in reconstructive breast surgery.  

#Explant #BreastImplantRemoval - Can new implants be inserted at time of removal?

Maybe.  It truly depends on how much tissue you have remaining, and what condition that is in.  It may not be possible to make this determination pre-operatively since removing your existing may result in too much tissue damage to (safely) insert implants at that time.

You should see several different board-certified surgeons in consultation before your surgery so that you have as much information possible ahead of time.  You may choose a different surgical plan based on all of this.

I hope that this helps and good luck,

Dr. Alan Engler
Member of #RealSelf100

#Explant #BreastImplantRemoval - Can new implants be inserted at time of removal?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Maybe.  It truly depends on how much tissue you have remaining, and what condition that is in.  It may not be possible to make this determination pre-operatively since removing your existing may result in too much tissue damage to (safely) insert implants at that time.

You should see several different board-certified surgeons in consultation before your surgery so that you have as much information possible ahead of time.  You may choose a different surgical plan based on all of this.

I hope that this helps and good luck,

Dr. Alan Engler
Member of #RealSelf100

26 years ago, I had Bilateral mastectomy with implants. Implants have ruptured. Can new implants be inserted at time of removal?

Each case has to be individualized.  In many cases implants are replaced at the same time that the old ones are removed.  Discuss your concerns with your surgeon.  Otherwise, seek a second opinion.  Always, see a Board Certified Plastic Surgeon.

26 years ago, I had Bilateral mastectomy with implants. Implants have ruptured. Can new implants be inserted at time of removal?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Each case has to be individualized.  In many cases implants are replaced at the same time that the old ones are removed.  Discuss your concerns with your surgeon.  Otherwise, seek a second opinion.  Always, see a Board Certified Plastic Surgeon.

Planning implant replacement after breast reconstruction

Thank you for asking about your breast implant exchane.

  • Usually, implants are placed at the same time that the old ones are removed -
  • Unless there is extensive silicone leakage outside the capsule, which you don't have.
  • But these old implants do create intense, thick, calcified capsules which must be removed.
  • It is (usually) fine to remove the capsule, revise the pocket as needed and place new implants.
  • If the capsule is difficult to remove, bleeding may make it necessary to put in a new implant later. 
  • I would ask your surgeon to explain his thinking about your needing two operations -
  • If you aren't sure that it is necessary, consider a second opinion before surgery.
Always see a Board Certified Plastic Surgeon.
Hope you find this information helpful. Best wishes

Planning implant replacement after breast reconstruction

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Thank you for asking about your breast implant exchane.

  • Usually, implants are placed at the same time that the old ones are removed -
  • Unless there is extensive silicone leakage outside the capsule, which you don't have.
  • But these old implants do create intense, thick, calcified capsules which must be removed.
  • It is (usually) fine to remove the capsule, revise the pocket as needed and place new implants.
  • If the capsule is difficult to remove, bleeding may make it necessary to put in a new implant later. 
  • I would ask your surgeon to explain his thinking about your needing two operations -
  • If you aren't sure that it is necessary, consider a second opinion before surgery.
Always see a Board Certified Plastic Surgeon.
Hope you find this information helpful. Best wishes

Implant exchange

Many times an exchange can happen at the same time as implant rupture removal, but each case has to be individualized., and I do not have all the facts.

Implant exchange

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Many times an exchange can happen at the same time as implant rupture removal, but each case has to be individualized., and I do not have all the facts.

Removal and replacement of implants

It is rare following a mastectomy that your surgeon would recommend removal of your implants without the placement of new ones.  I might understand that to be the case if you are requesting a significantly smaller size but that does not necessary preclude you from having it done simultaneously.  It is possible that I am missing a piece of vital information that may change my recommendation but a second opinion would certainly seem reasonable.

Removal and replacement of implants

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
It is rare following a mastectomy that your surgeon would recommend removal of your implants without the placement of new ones.  I might understand that to be the case if you are requesting a significantly smaller size but that does not necessary preclude you from having it done simultaneously.  It is possible that I am missing a piece of vital information that may change my recommendation but a second opinion would certainly seem reasonable.

Breast implants removal and replacement

It should be possible to remove the old broken implants and replace new ones at the same time, unless your doctor knows some piece of information that is missing from your description. The fact that the rupture is intracapsular would also play in favour of an immediate replacement.

Breast implants removal and replacement

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
It should be possible to remove the old broken implants and replace new ones at the same time, unless your doctor knows some piece of information that is missing from your description. The fact that the rupture is intracapsular would also play in favour of an immediate replacement.

Hard to tell without examining, but...

...new implants should be able to be placed at the same time unless there are extenuating circumstances.  Perhaps get a better, more detailed answer as to why your surgeon wants to wait.  You could also consider getting different opinions by board certified plastic surgeons.

Hard to tell without examining, but...

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
...new implants should be able to be placed at the same time unless there are extenuating circumstances.  Perhaps get a better, more detailed answer as to why your surgeon wants to wait.  You could also consider getting different opinions by board certified plastic surgeons.

Breast Reconstruction

Intra-capsular silicone implant rupture require enblock removal of the implant with the capsule. As intact as possible to avoid and minimize contamination of the tissue with silicone. The breast can then be reconstructed with new implant and probably need Acellular matrix. Otherwise the skin can shrink some if the reconstruction is delayed.Will require expert surgeon to do all this.

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

Breast Reconstruction

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Intra-capsular silicone implant rupture require enblock removal of the implant with the capsule. As intact as possible to avoid and minimize contamination of the tissue with silicone. The breast can then be reconstructed with new implant and probably need Acellular matrix. Otherwise the skin can shrink some if the reconstruction is delayed.Will require expert surgeon to do all this.

Samir Shureih, MD
Baltimore Plastic Surgeon

I would get another opinion

Unless there is an infection I see no reason that you could not put implants back in. I would seek another opinion from a Plastic Surgeon certified by the American Board of Plastic Surgery.  And at age 62 I would consider the new Ideal Structured implant, if you leak again in 20 years it will be easier to deal with. Jane.

I would get another opinion

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Unless there is an infection I see no reason that you could not put implants back in. I would seek another opinion from a Plastic Surgeon certified by the American Board of Plastic Surgery.  And at age 62 I would consider the new Ideal Structured implant, if you leak again in 20 years it will be easier to deal with. Jane.

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.