Is It Safe to Have my Lymph Node Filled with Silicone Removed?

Question

Hello, I had a ruptured PIP implant removed (left side). Unfortunately I now have an enlarged lymth node (2.9cm) which is very uncomfortable. I am been advised not to have them removed as I could end up with lymthodema in the arm and be prone to catching infection. I have also been advised that it is safe to remove. Another surgeon also said that the human body would break it up but he didn't say over what period of time. Please could you kindly advise. Thank you

Lu-Jean Feng, MD · Answer

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.

Stephen Bresnick, MD · Answer

A significant silicone implant leakage can cause free silicone to collect in a lymph node.  I have assisted several patients with this problem.   The good news is that my patients have had spontaneous resolution over time.  They have not needed surgery.  In those cases, more than a single node was involved and there was little discomfort from the area.   Although removal of a single node is unlikely to cause lymphedema, there is no real guarantee that other nodes may not enlarge or that your discomfort will be alleviated.  Has your doctor attemped to aspirate or drain the node?   This may be a first good step.

	Best wishes!    Dr. Bresnick

Jourdan Gottlieb, MD · Answer

As large and symptomatic as this node is, it makes sense to have it removed. The chances of lymphedema from the removal of a single abnormal node is quite remove, the benefits fo relieving the discomfort are clear.

	Thank you for the question at best wishes.

Tom J. Pousti, MD · Answer

I'm sorry to hear about the complication you have experienced.  Although I cannot give you precise medical advice without direct examination ( and full consultation)  some general advice may be helpful to you.

	Given that the lymph node is enlarged and symptomatic, I would suggest that it be removed.  In my opinion, it is unlikely that removal of a single lymph node would lead to  lymphedema of  the extremity.  Furthermore, there is no guarantee that the body will “break it up”.

	I would suggest in-person consultation with the most experienced board-certified plastic surgeon in your area.

	I think you will find the attached link helpful.

Is It Safe to Have my Lymph Node Filled with Silicone Removed?

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