Silicone Breast Implants Done in 1972. Recent MRI Completed - Remove or Leave Alone?

MRI:Rt Breast-small zone of posterior contained intracapsular implant rupture,subcentimeter area.No evidence for parenchymal silicone or gel bleed.Medial capsular contracture & water density infiltration but no rupture.Left Breast-Definite positive keyhole findings of contained intracapsular implant rupture w/out evidence for parenchymal silicone deposition. Both-No evidence for implant collapse.What is potential of en-Bloc removal w/no breakage,fully clean area&replace w/new silicone implants?

Doctor Answers 24

Is it possible to remove a ruptured silicone implant which is confined to the capsule without silicone contamination of tissues.

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I have removed many old silicone implants without contaminating the tissues. If one can make a large enough incision, it is easier to remove the capsule and the implant without opening the capsule. If I try to remove the implant through the insertion scar, I separate most of the capsule from the tissues then pack a pad around it to prevent contamination, open the capsule, remove the implant material and finally remove the capsule.

Silicone implant failure

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Failure of the implant is an indication to have it removed and replaced.  For extracapsular rupture, this is a more pressing issue.  Intracapsular rupture can cause capsular contracture, breast distortion, and can progress to extracapsular rupture.  Removing all of the implant material requires careful capsulectomy.  The capsule is removed with the implant and material contained within the capsule. 

Read my blog post below for more details on silicone implant rupture.

Dr. York Yates - Utah.

York Jay Yates, MD
Salt Lake City Plastic Surgeon
4.9 out of 5 stars 190 reviews

What to do with ruptured 38 year old implants

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Given their age of over 38 years, there is no doubt that these silicone implants need to be removed - along with the surrounding capsule and any free silicone (as much as possible). Depending on your specific situation, either new implants can be placed at that time or at a later date.

Steven Turkeltaub, MD
Scottsdale Plastic Surgeon
4.7 out of 5 stars 33 reviews

Removal of the broken implants, the scar capsule and any loose silicone will make a big improvement

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The implants made in the 70s were very thin walled and had very liquid silicone gel. Essentially all of them have failed and need to be removed with the over lying scar and any loose silicone or silicone granulomas. The good news is that this should be relatively easy from your description  of your breast. Along with this you could have a breast lift or new and much better implants or both. Interestingly  my patients like you feel so much better after surgery because their breast are again soft and don't hurt.

Carl W. "Rick" Lentz III, MD
Orlando Plastic Surgeon
5.0 out of 5 stars 17 reviews

Leaking Silicone Breast Implants SHOULD be Replaced or Removed

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Leaking Silicone Breast Implants should be removed or replaced. In all such cases the surgeons tried to separate the implant scar envelope (capsule) from the adjacent tissue and remove the implant and its spilled content EN BLOCK. However, that is not always possible and sometimes entry is made into the capsule forcing the spilled silicone to be suctioned or removed by hand. Either way, the pocket is then washed, removing all contents and either a new implant is placed or it is closed without an implant. It is not always possible to predict the chances of full en block removal until the surgeon encounters the capsule in surgery. Good luck. Dr. Peter Aldea

Peter A. Aldea, MD
Memphis Plastic Surgeon

Worn silicone gel breast implants, remove or not

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After 30 years, it can be expected that most silicone gel breast implants will have developed a leak in the outer shell, and the silicone gel inside will leak into the scar capsule formed around the breast implant. The MRI may help you reach a decision, however the result is hardly a surprise. The implant can be replaced when you are 'ready' though as the gel contacts the capsule you may experience a drawing sensation and firming of the implant. Over time the capsule will calcify. The best choice is implant removal and replacement. Often complete capsule removal is required but the condition can be determined at the time of replacement. En bloc if a fancy word for in one piece, and the incision may be larger than what you had prior. As long as all gel is washed clear you should do well.

Best of luck,

peterejohnsonmd

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 44 reviews

Intracapular rupture of silicone implants

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Although an intracapsular silicone implant rupture will not necessarily result in silicone leaking through out your body, it is recognized that silicone rupture will result in silicone molecules in the capsule promoting capsule thickness that will eventually deform your breast. It is a good idea to remove any ruptured implants as soon as possible.

Arian Mowlavi, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 108 reviews

Old ruptured silicone gel implants

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It is advisable to have the implants removed, and replaced if desired, if they are ruptured.  old implants were of poorer quality and often had liquid silicone inside them rather than the semi-cohesive silicone now used.

Often, if women have gained weight over the years and their breast size is larger, it is possible to remove the implants completely and perform a breast lift.

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 195 reviews

Ruptured Silicone Implants

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The potential for en-bloc removal of the implants is higher if they were placed above the muscle. Nonetheless, whether or not en bloc removal is possible, if there is a diagnosis of silicone implant rupture you should have the implants removed.

Hope that helps and good luck!

Dr. Babak Dadvand

Babak Dadvand, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 51 reviews

Silicone Breast Implants Done in 1972. Recent MRI Completed - Remove or Leave Alone En bloc

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In simple terms the possiblity of removing the vast majority (but not 100%) of the silicone remains an option. However, please realize that a ruptured implant should be identiifed and removed.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

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.