Replace Implants After Silicone Leakage?

My wife had breast augmentation done in Costa Rica seven years ago. Her doctor in CR (she is Costa Rican) offered to do a replacement, but has stated that he will take the old ones out and just put new ones in, at a reduced price. He has seemed alittle hesitant to explain the process.Hers were inserted through the nipple and under the muscle. I have read that replacements should not be put in unless the area is irrigated and cleaned of loose silicone. Is this correct?

Doctor Answers 7

Silicone implant rupture and treatment.

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The recommended treatment is for implant removal and removal of as much loose silicone as possible. It would be highly unethical to leave free silicone without attempting removal. Several questions arise with surgery in a foreign country - what type of implants are used? what if a complication arises when you get back home - who takes care of your wife? Who is the doctor and is he credentialled in any way? Why the reduced price? Is he using PIP implants or other faulty devices? Unfortunately, these questions are often asked AFTER there is an issue. Several insurance companies will cover the costs of removing ruptured silicone gel implants should they impact breast cancer surveillance. Although this coverage is becoming more rare as the years go by, it is worth investigating prior to buying a ticket to Costa Rica. I recommend seeing a couple of Board Certified Plastic Surgeons where you live.

Boca Raton Plastic Surgeon
5.0 out of 5 stars 26 reviews

Implant replacement

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I would discuss this with the doctor.You never get 11% out but you remove any loose silicone and irrigate and put in new imp[lants.

Robert Brueck, MD
Fort Myers Plastic Surgeon
4.9 out of 5 stars 69 reviews

Breast implant replacement after silicone leakage

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Old ruptured implants should be removed since leaking silicone will continue to cause problems over time.  The standard procedure would be removal of all implant remnants, removal of most if not all of the implant capsule, and irrigation of the pocket.  New generation implants can then be placed if desired.


If her surgeon is less than forthcoming during discussion of the surgery you should be hesitant and seek another opinion.  The surgeon's obligation is to fully prepare the patient and to provide all necessary information to enable the patient to make an informed decision.

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Removal of ruptured breast implants

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Old ruptured implants should be removed as best can be done with irrigation of the pocket and in total the capsule that surrounds each implant.  There should be no reason  for you to avoid replacing the implants, and this can be done through the original incision if you desire.  Be sure that all of the material of the implants are removed if at all possible.  Also inquire as to whether the original implants were manufactured be PIP , and if they were they  certainly should be removed as soon. as possible.  They have been proven to be  inferior to the manufactured by the excellent breast implant companies Mentor , Allergan  and Sientra 


Good luck to you.


Frank Rieger M.D.  Tampa Plastic Surgeon

Silicone Leakage

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When removing a leaking gel implant an attempt should be made to remove all free silicone, and where possible all silicone infiltrated tissues, which typically is limited to the capsule that forms around the implant. It should be possible to do this through her original incision. This can be more difficult than the original insertion, and can result in a higher rate of post-op complications. I would strongly consider doing this procedure nearer to your home, and a consultation with a plastic surgeon can sort out her options.

Thanks for the question, and best wishes.

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

Implants done in Costa Rica

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You are correct.  When replacing implants, the pocket is irrigated with an antibotic solution and any silicone material is removed.  I would recommend that your consult with a Board Certified Plastic Surgeon certified by the American Society of Plastic Surgeons ( ASPS) to discuss you concerns. 

Robert E. Zaworski, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 61 reviews

Replacing Breast Implants after Ruptured Silicone Breast Implants?

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Yes, you are correct in that removal of any free silicone material is a standard part of the procedure your wife will require if she has experienced leakage from a silicone gel breast implant. Generally speaking, this operation is done through the previous incision and is associated with less discomfort and/or recovery time compared to the initial sub muscular breast augmentation procedure.

I hope this helps.

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.