You have left a lot of information out, but from what you have told us you are between a rock and a hard place. The surgery itself is not the problem; it's the anesthesia. MG can attack any of your muscles including respiratory ones. Conventional wisdom says that muscle relaxants need to be used sparingly by the anesthesiologist and that they should be reversed at the end of the case. There is a still the small possibility that your breathing muscles will be affected and you could have to be ventilated by a machine in the hospital until your muscles are working again. This is rare, but still a concern. You have to weigh that against the risks associated with your ruptured implants. You didn't say whether the extracapsular silicone is itself encapsulated which is sometimes is. If so it's no worse than the silicone the remains in the capsule which may have been there for years without causing you problems. If the extracapsular silicone is embedded into the tissues chances are that not all of it will be removed with surgery anyway. There is no evidence to show this will cause you a problem. At some point your capsules will become calcified and hard. That may be another reason added to the others to want them removed. I would find a center (most likely a University) that deals with lots of MG patients and approach them with the question of anesthetic risks. There are surgeries done to help people with MG that I am sure your diagnosing physician will know about. I am certain that a surgeon that does them (thymectomies) would work closely with his anesthesiologist on these cases and know the risks. They would be a good resource for information. These are not common procedures at all, but I know there is a surgeon in Orange County California that does them because he did my cousin's (and he had no problems). Good Luck
