Silicone Nodules in Armpit from Ruptured Implant

Silicone nodules in the armpit and soft tissue of the chest can occur after migration and lymphatic progression of silicone particles. This is a reflection of the implant rupture and the viscosity of the silicone in your implant rather than the technique of your correcting reconstructive surgeon. It is very difficult to entirely remove all the silicone in some cases, while in other cases of silicone rupture it can be quite easy and straightforward.
I would address these nodules individually as they arise as there is no single definitive surgery that will address all the silicone in your body at once.

Sorry to hear about your predicament. Silicone implants have been reengineered significantly, since their development in the mid-60's. Generally, the manufacturers have made the gel "stickier" or cohesive. The implication for the patient is that in the event that the external shell fails, the filler doesn't travel all over the place. However if you had a significant chest trauma, which caused your implants to leak, the gel could still have been dislodged. The body is a remarkable system, which works to "contain" foreign particles, such as free silicone, either in "lumps" called granulomas or by moving free floating particles along to the regional lymph nodes, where they become apparent as "knots" in the armpits, groins, neck, etc.
Many plastic surgeons have taken care of patients who have had the older generation implants which failed and may have developed these lumps. The management is usually based on how many symptoms they cause. In your case, the pain you are experiencing may be a necessary and sufficient reason to operate, however as the other consultants have outlined, it is important to realize that every operation has some risk. The armpit is an interesting structure which contains many important nerves, blood vessels and lymphatics. It would be advisable to select a surgeon who is familiar with the anatomy but you stil run the risk of numbness, damage to blood vessels and swelling of the entire arm, if the lymphatic system is damaged. The latter condition, lymphedema is really difficult to manage and irreversible. Ask your family physician or local medical society for a referral to a breast oncoplastic surgeon. Good luck.