I've had silicone breast implants for over 30 years with no problems. Now despite even an MRI, doctors are undecided if the implant is ruptured or not. How urgent is it to get free silicone out of the breast and what does happen to free silicone? What is the proceedure to remove the silicone?
What Happens to Silicone Leaked into Breast Tissue?
Doctor Answers 4
Removal of silicone
An MRI done with breast coils should pick up 90% of leaking or ruptured silicone implants. If I suspect a ruptured silicone implant I dissect around the capsule before opening it and potentially exposing raw silicone. This helps keep spillage of silicone to a minimum. When silicone gets out into the breast tissue, your body walls it off with scar tissue called granulomas. The only way to get rid of this is to cut out the granuloma including the breast tissue involved.
Leak of silicone filled breast implants. Capsulectomy for silicone breast implants leak.
Discrete leaks of filler of the implant can be very difficult to diagnose.
It is important that you obtain a opinion from a plastic surgeon who is familiar with the problem. Certain radiology departments are more familiar with the interpretation of breast MRI's for implants leaks.The best way to diagnose the problem is the combination of clinical examination and if the suspicion is high ultrasound followed by MRI is the way to make the diagnosis. Micro leaks usually are silent and remain undetected. Larger leaks causing symptoms are more easy to diagnose.
Once the silicone filler of the implant has leaked out of the shell, the body surrounds it with capsule similar to the one around your breast implant. The capsule can vary in thickness. The silicone is relatively inert material and will remain in place of encapsulated. This subject has been studied extensively and in absence of severe systemic autoimmune disease e.g rheumatoid arthritis, Lupus or other it will not affect your health and it is not an emergency. In presence of symptoms-e.g. pain, pulling, change of breast shape, palpable mass or interference with the regular breast exams exchange of the implants and removal of the capsule surrounding the implant and the loose silicone material should be considered. The procedure is also known as capsulectomy and may vary of its extend in every patient. If the breast implants are exchanged to new implant they are usually similar to the shape of the implant used before. Associated issues like correction of sagging can be addressed in the same time. If the choice just to remove the implant usually breast lift is required to preserve the shape to a previously augmented breast. A board certified plastic surgeon will help you decision making according to your desires and concerns.
Last your psychological well being is also important. If the possibility of leaking implant makes you uncomfortable you should consider exchange of the implants.
Thirty year old breast implants and question of rupture
IF the MRI cannot detect an implant rupture the silicone extravasation must be realtively negligible. Nonetheless,. the recommended management would likley be implant removal with capsulectomy and consideration for replacement if desired.
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If a patient has a ruptured silicone implant I prefer to remove it as convenient as it is for the patient. Usually it is self contained within the capsule and it is fairly easy to remove.