Am I endangering my health if I don't have my ruptured implant removed?

Medicare does cover the removal of old ruptured gel implants. The longer the silicone stays, the more risks of scar tissue and thicker capsule occurs. It would be best to removed your old implants.

If you have not noticed any distortion, shrinkage, or discomfort in the breast, it may be okay to not explant.  If remaining silicone material has extruded, the implants should be replaced but this is not an emergency situation. In fact, they may have been ruptured for quite some time.  The free silicone will not travel to other parts of the body because the capsule around the implant  prevents that from happening. Silicone is relatively inert, and I would not anticipate a change in antibodies after removal.    

In general when a capsule is formed and there is a rupture of silicione gel, the capsule encloses the  implant and gel material and prevents any of the gel getting into the breast tissue.  In certain cases I have seen the gel travel thru a thin or ruptured capsule and get into the tissue and skin which can be a big problem.  Although this is very rare it could have been prevented.  A capsulectomy and removal of silicone implants, especially when in front of the muscle, is a very simple procedure and can be done very quickly and safely in experienced hands.I would recommend you see a board certified plastic surgeon to discuss things further.Hope that helps.