Leaking silicone breast implant, how fast does it need to come out?

Question

Hi. I got my first set of implants above the muscle when I was 26. Then lost weight and could see ripples. In 2013 had them replaced beneath the muscle, textured. Had lots of trouble with hematomas Seroma’s. Had another set put in 2014. This past September had a mammogram and showed fluid around the capsule along with a keyhole leak current something after mammo as Rt breast doubled in Sz and is by my armpit. I have lupus RA already. Surg scheduled April. Should I push for quicker time?

Alan Gonzalez, MD, FACS · Answer

Hello @Aernst321, thank you for your question. As fast as you can, if you feel like you can push for earlier, do it. This will help to relieve your symptoms and regulate the body sooner. However, not only the implants need to be removed, but also the capsules surrounding the prosthesis. It would be necessary to carry out a preventive biopsy on each capsule. There is a video about ruptured implants that sheds some light on the subject. If you are considering a breast explantation, consultation with a plastic surgeon who is experienced in this procedure is essential to ensure optimal results. Best wishes! Alan Gonzalez MD, FACS. American Society of Plastic Surgery Member (ASPS), International Federation for Adipose Therapeutics and Science” Member (IFATS), Colombian Society of Plastic Surgery member (SCCP)

Robert M. Wald, Jr., MD · Answer

I would highly recommend that you move up your surgery. You don't want to keep this fluid for several months. There is a chance of infection and the fluid potentially could cause bleeding. There is also a rare potential for a lymphoma with the textured implants.

Raffy Karamanoukian, MD, FACS · Answer

Removal of breast implants, intact or ruptured, may have positive implications if patients are symptomatic. A constellation of symptoms associated with breast implant illness, and autoimmune disease are considered when treating patients who have breast implants and are concerned about foreign body reaction. In our office, we begin this journey with a consideration of symptoms and exclusion of obvious autoimmune problems. In many of our patients, en bloc removal of breast implants with capsulectomy is important and beneficial. Further clinical evidence about breast implant illness is evolving and will continue to guide treatment. I would suggest removal if there is a possibility of foreign body reaction.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Shaher W. Khan, MD · Answer

I suggest to all of my patients to have the implants removed sooner than later. Silicone toxicity is a serious issue.

Daniel Barrett, MD · Answer

Dear Aernst321,
it is hard to tell for sure without an examination. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Camille Cash, MD · Answer

I'm sorry to hear about the issues you are having.  Though your situation is not an "emergency" it is best to have the implants removed as soon as it is comfortably feasible, especially given your contributing diagnosis.  I encourage you to speak with your surgeon about your concerns as she/he has had the opportunity to examine you and review your complete medical history.

Connie Hiers, MD, FACS · Answer

Implants used since 2007 are the newer gel implants in which the gel is not like "honey" but more like "jello" and is not liquid. You might still have some fluid around your implant. The capsule may have torn and allowed the implant to move to your axilla. If you are in pain, ask your surgeon if you can move your surgery up sooner.

Mark A. Schusterman, MD, FACS · Answer

Thank you for your question.  I definitely think you should push for earlier surgery.  Although its not an emergency it is somewhat urgent to get it removed and along with the capsule.

Derek Fletcher, MD - Account Suspended · Answer

You have two separate problems: fluid around the implant and implant rupture. These problems may or may not be related. 
A large collection of fluid around a textured implant is concerning because it may represent breast implant associated anaplastic large cell lymphoma (BIA-ALCL). I recommend ultra sound guided aspiration of the fluid around your implant and sending the fluid for evaluation to rule out BIA-ALCL. Knowing this detail is critical to planning and timing surgery. To be clear, the likelihood of having BIA-ALCL is very low, but I would want to confirm that as soon as possible. Knowing exactly which textured implant you have can tell me roughly how high the risk of BIA-ALCL is.
In my practice, I remove ruptured silicone implants as soon as possible simply because cleaning a small amount of leakage is much easier than cleaning a large leak.

Leaking silicone breast implant, how fast does it need to come out?

Answers (9)

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