My mother (who is 78 years old and has almost no natural breast tissue) has had multiple ruptures (due to mammograms) of her liquid silicone implants from 1975, but the Toronto surgeon who implanted them originally told her it's too risky to remove them, that the liquid silicone would just spread further. She has very bad capsular contracture but, amazingly, feels ok otherwise. What do you suggest?
Answer: Advocate removal without replacement A breast implant develops a fibrotic capsule with time that holds the implant in position. This is a normal process. The older implants were made of a polymer shell containing a liquid silicone oil, as opposed to the cohesive gel (gummy bear/non liquid) that are now available. Over time the polymer shell weakened and the oil leaked out of the implant. The first step is leakage into the area inside the capsule - Intracapsular (IC) rupture. Over time, the silicone extrudes through the capsule and becomes Extracapsular (EC) rupture. This can be asymptomatic or can become noticeable as palpable lumps or irregularities around the implant; contractures, muscle firmness, skin discoloration, infection, etc. It may affect breast screening for breast cancers. There has been no evidence that silicone from a ruptured implant causes cancer, autoimmune diseases or systemic problems. It is great that your mother feels OK. There is no medical urgency. In the last 20 years I have seen several of these cases. If the women are medically stable, I prefer to remove the implants, silicone, and surrounding tissue and leave a small drain. This is outpatient surgery. The women have done well and there has been a sense of release of pain from the contracture and weight. Respectfully, Jules A Feledy, Jr, MD American Board of Plastic Surgery, American Society of Plastic Surgery
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Answer: Advocate removal without replacement A breast implant develops a fibrotic capsule with time that holds the implant in position. This is a normal process. The older implants were made of a polymer shell containing a liquid silicone oil, as opposed to the cohesive gel (gummy bear/non liquid) that are now available. Over time the polymer shell weakened and the oil leaked out of the implant. The first step is leakage into the area inside the capsule - Intracapsular (IC) rupture. Over time, the silicone extrudes through the capsule and becomes Extracapsular (EC) rupture. This can be asymptomatic or can become noticeable as palpable lumps or irregularities around the implant; contractures, muscle firmness, skin discoloration, infection, etc. It may affect breast screening for breast cancers. There has been no evidence that silicone from a ruptured implant causes cancer, autoimmune diseases or systemic problems. It is great that your mother feels OK. There is no medical urgency. In the last 20 years I have seen several of these cases. If the women are medically stable, I prefer to remove the implants, silicone, and surrounding tissue and leave a small drain. This is outpatient surgery. The women have done well and there has been a sense of release of pain from the contracture and weight. Respectfully, Jules A Feledy, Jr, MD American Board of Plastic Surgery, American Society of Plastic Surgery
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Answer: Explant Good evening,
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Answer: Explant Good evening,
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March 3, 2022
Answer: Removal I would suggest that she see another plastic surgeon who will remove the capsules with the ruptured gel implants. It is possible, that all of the gel may not be able to be removed if the capsules have torn and leaked gel. She will need a medical clearance for elective surgery.
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March 3, 2022
Answer: Removal I would suggest that she see another plastic surgeon who will remove the capsules with the ruptured gel implants. It is possible, that all of the gel may not be able to be removed if the capsules have torn and leaked gel. She will need a medical clearance for elective surgery.
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February 13, 2022
Answer: Implant removal Dear FairWanderer,
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February 13, 2022
Answer: Implant removal Dear FairWanderer,
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February 13, 2022
Answer: Breast implant removal Thank you for the question. Provided that your mother is in good health, removing the implants and at least part of the capsule should be possible and safe, including the evacuation of all the silicone material. I hope this helps. Vasileios Vasilakis, MD. Double board-certified, fellowship-trained plastic surgeon, Houston. TX.
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February 13, 2022
Answer: Breast implant removal Thank you for the question. Provided that your mother is in good health, removing the implants and at least part of the capsule should be possible and safe, including the evacuation of all the silicone material. I hope this helps. Vasileios Vasilakis, MD. Double board-certified, fellowship-trained plastic surgeon, Houston. TX.
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