Ruptured Implant and Silicone in Lymph Node

I have done extensive research on silicone lymphadenopathy over the last 20 years as a result of breast augmentation. As a result, I have published a peer-reviewed paper with scientists from the Armed Forces Institute of Pathology in Washington, D.C. as well as from Case Western Reserve University in Cleveland. Silicone in the lymph nodes can be diagnosed by ultrasound and localized by needle localization for precise removal. The polyurethane covered gel filled breast implants are associated with extensive silicone lymphadenopathy in the axilla, retropectoral, internal mammary, and sometimes neck nodes, but never in nodes below the diaphragm. The saline implants are never associated with silicone lymphadenopathy. Ruptured gel implants are only sometimes associated with silicone lymphadenopathy. 

Silicone-laden lymph nodes, if they need to be removed, should only be removed after needle localization by a radiologist experienced with the technique. I have removed many silicone laden lymph nodes after needle localization in the past, but I have stopped due to the fact that the removal makes little difference in patient's recovery from implant illness. In addition, there are always risks of lymphedema of the arm, numbness in the arm, and seroma in the axilla. I am not aware of any medical literature showing benefit of lymph node removal in implant illness. Linked is my peer-reviewed research study on silicone and lymph nodes

         Silicone breast
implants are not intended to last a lifetime and occasionally these devices
fatigue and rupture. When this happens, the silicone is usually contained
within the fibrous capsule that surrounds the implant.

 

         Although removal of
ruptured silicone breast implants is not an emergency, most surgeons agree that
ruptured implants should be removed as soon as possible. When ruptured silicone
implants are left in place for prolonged periods of time, the silicone can
actually leak into the surrounding tissue and lymph nodes. This can result in
an inflammatory process known as a silicone granuloma. Although this problem is
not life threatening, it can make subsequent reconstruction more difficult.

 

         When ruptured
implants are removed, it may be necessary to remove the breast capsule as well.
In most cases, new breast implants can be placed during this operative
procedure. 

Ruptured Silicone Implants should be removed and replaced. Typically removal of the surrounding capsule (Capsulectomy) is also performed to remove traces of silicone. The likelihood of this happening would be more likely prior to 2006 especially after trauma. After 2006 silicone implants were all more cohesive (more gel like).

 I would recommend removal of  silicone filled lymph nodes (grossly filled, not microscopic) if lymph nodes are enlarged or easily accessible be removed and tested. The likelihood that is involved in serious condition is very rare and in fact, I reported on one of the few ever reported which occurred in more than 25 years of practice.

A ruptured implant should be replaced at a convenient time for the patient. It is not an emergency and will cause no long term health problems. The silicone will be contained by the capsule that forms around all breast implants.
It is unnecessay to remove lymph nodes if silicone is suspected. Probably everyone in this country has molecular silicone in a lymph node somewhere. Injection needles are lubricated with silicone so anytime you get a medical injection or IV, some silicone is shed into the blood and ultimately filtered through the lymphatics.

The treatment depends on which silicone implant was utlized.
The more cohesive gel impants are quite firm and do not easily spread when ruptured. However, the less cohesive gell implants can diffuse throughout the breasts. This can be quite a mess to clean up. Therefore it is best for you to find and treat these as soon as possible.