Removing Silicone Implants Under Local Anesthesia?

I am given to option to get my implants removed under local anesthesia, however I have 4 year-old silicone implants and never got a MRI or mammogram to check if they were ruptured. What happens if I select local anesthesia and then during the surgery, we find out that they were leaking? Would local anesthesia be enough? What about adding some IV sedation? I probably don't have the liquid silicone, my breasts are relatively soft but do have 1 knuckle near the cleavage & lower-pole.

Doctor Answers 9

Removing silicone implants under local anesthesia?

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Thank you for your question! Depending on your and your plastic surgeon's comfort level with surgical procedures via local anesthesia, it certainly is a safe procedure and can be done via local only or a little sedation. It is difficult to answer about the appearance of your breasts without a photo or examination. Removal of your implants alone will create a smaller breast with somewhat similar shape. Discuss your concerns with your plastic surgeon and the possibility for a breast lift, either at the same time or at a later date, if deemed necessary. Many times drains are placed as well as compression garments used postoperatively. Cost varies among surgeons as well as geographic location. Certainly, for simple removal without any capsule work, the procedure can be tolerated with local anesthesia alone. I typically prefer to remove the capsule.  Best wishes!

Removing a silicone gel implant under local anesthesia

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Removing silicone implants can be done under local in some cases.  If your implants are less than 4 years old it is unlikely that they are ruptured.  The capsule would only need to be removed if it was an old styled implant made prior to 1999.

Removal of silicone implants can be performed easily under local anesthesia, but should it be done every time?

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Although it is possible to perform simple implant removal under local anesthesia, if anything needs to be done to the capsule, this is difficult to do like that.  You note that your capsule is supple, and that your implants are only 4 years old.  It is doubtful that you have a ruptured implant, and "leak" really doesn't happen with these newer implants as they really behave physically more like a solid.  At this point I think an MRI is unnecessary, and I would only get a mammogram if you were due to get one or there was some problem with the breasts that needed to be evaluated.  It seems as though you may be a bit of an anxious girl who gets nervous in medical situations, and for that reason alone I would strongly be in favor of at least some intravenous sedation at the time of explantation, if not just a very quick and light general anesthetic.  Everyone will be more comfortable then, you and the surgeon both, and that way he can do what he needs to do without worrying about making you anxious or hurting you.

Joseph L. Grzeskiewicz, MD
San Diego Plastic Surgeon

Is it a good idea to remove breast implants under local anesthesia? Ask Dr Ellen

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Hello OCDGirl,

I am inclined to be conservative when it comes to surgery and prefer to be prepared for all possible outcomes.  For the reasons you described and many others, I would choose to perform the surgery in an operating room and have available to me all the necessary equipment, safety measures, staffing, anesthesia and sterile environment to provide to you the best outcome.

Thanks for asking!  Dr Ellen

Removing Silicone Implants Under Local Anesthesia?

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       Removing implants under local anesthesia is appropriate only in the simplest case of pure removal.  I always have an anesthesiologist available.   Kenneth Hughes, MD Los Angeles, CA

Removal of Silicone Gel Breast Implants and Type of Anesthesia?

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Saline or silicone gel breast implants can certainly be removed under local anesthesia, given the right “circumstances” and the right patient. However, if there is a rupture of the gel implant  or capsulectomy (or other type of capsule work) is planned, sedation is probably a good idea.  Best wishes.

Removing silicone implants

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Removing silicone implants can be done under local in some cases but you may want anesthesia for comfort and if the capsule has to be removed.  Good luck.

Removing silicone gel implants under local anesthesia

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Assuming an inframammary crease incisional scar/approach and no reason to suspect the implants are ruptured and no need to remove any capsule, I would agree with Dr. Gottlieb that this can be done with local anesthesia alone. Saline-filled implants are even easier. If I don't know the exact type, age, and condition of silicone gel implants, I would recommend the procedure be done under local anesthesia with IV sedation which is what I do for all breast procedures. That would cost somewhat more and most plastic surgeons are not comfortable and experienced with that but general anesthesia should not be needed for a simple implant removal. 

Scott L. Replogle, MD
Boulder Plastic Surgeon

Removing Silicone Implants Under Local Anesthesia?

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It is quite easy to remove implants with local anesthesia only, but it is not easy to remove a capsule if that were needed. But the chances are so small that you have a rupture, I would go ahead as planned. An MRI, the gold standard for leaks, would probably cost more than your current surgery. 

All the best. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

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.