20 year old saline implants hardened - what could be the cause?

Question

I have 20 yr old breast implants. The left has become very hard, and tender (painful at times). A recent ultrasound was normal. Recent mammogram showed no signs of cancer but the report said possible failure of left implant, obstructing views, so mammogram deemed inconclusive. My family doc suggests I see a plastic surgeon. If the implant/s has broken down somehow, will ohip cover removal? How common is this? And what would cause the breast to be very hard on the left side, and the tenderness.

J. Jason Wendel, MD, FACS · Answer

Thank you for your question regarding Implant Removal!

Often times implant firmness and pain can be a result of a capsular contracture. A capsular contracture occurs when the scar tissue surrounding the implant becomes hard and contracts. This can often times become very painful. An implant removal and capsulectomy is necessary to address a capsular contracture. The capsulectomy will remove the hard, contracted scar tissue surrounding the implant.

Insurance will sometimes cover the cost of an implant removal and capsulectomy; however, I encourage that you reach out to your insurance company to confirm this and find an in-network plastic surgeon in your area.

To be sure, see two or more experienced, board-certified plastic surgeons in your area for a complete evaluation to make sure you are a good candidate and that it is safe for you to have Implant Removal with Capsulectomy. I hope this is helpful.

Brian K. Reedy, MD · Answer

Thanks for your question! It's likely capsular contacture which is a hardening of the scar tissue around the implant. I agree that a consultation with a plastic surgeon is the right answer. It's probably time for implant replacement. Good luck!

Martin Jugenburg, MD · Answer

Hello, thank you for your question. Its possible you have a capsular contracture. The implant company will cover grade 3-4 capsular contracture. If it is causing you discomfort then you should see the plastic surgeon to examine you and discuss your options.

Albert Ko, MD · Answer

Hardness of implants is most likely caused by Capsular Contracture! The formation of scar tissue around implants, but sometimes that scar tissue can become hardended and damage the implants themselves. I would reccomend a consultation with a plastic surgeon to explore your options!

Fernando Ovalle Jr., MD · Answer

Hello and thank you for your question. In my opinion, your symptoms are very classic for grade 4 capsular contracture, which happens when the scar tissue layer which normally forms around an implants starts to thicken and in some cases contract and cause pain/discomfort along with changes in the position/shape of an implant. There can be many causes but sometimes the culprit is usually your body's reaction to a small rupture/tear of the implant shell from "normal wear and tear" over time. The treatment for this is capsulectomy (removal of the abnormal scar tissue layer around the implant, as well as removal of the implant. Please see a board certified plastic surgeon for an in-person consultation!

Daniel Barrett, MD · Answer

Dear Koremins,
I understand your concern. However, without a proper assessment, it would be difficult to determine what is wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Peter Andolina, DO · Answer

Based on your above description, it sounds like you have developed a capsular contracture. It is the body's natural response to form a capsule around a breast implant over time. A capsule can thicken over time and make a patient's breast start to feel hard. Over time this process can start to become painful and can even cause distortion of the breast in some patients. In regards to getting any sort of procedure covered, its going to depend on the coverage or policy you have on your breast implants. I would try to get in with a plastic surgeon in your area in order to be examined and to go over your options.

Connie Hiers, MD, FACS · Answer

When saline implants break, you deflate and go flat, and your body absorbs the salt water. It appears you have developed a capsule.  Go visit with a plastic surgeon.

Camille Cash, MD · Answer

An exam is needed to know for sure but you may have developed capsular contracture.  This is when the scar tissue that is around the implant becomes thickened or hard and contracts or squeezes around the implant.  An exam by your surgeon can help diagnose this.  I've included a video that I hope you find helpful.

20 year old saline implants hardened - what could be the cause?

Answers (9)

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