MRI shows a small amount of fluid behind 22 year old textured silicone implants. Should implants be removed?

Question

I have had 4 MRIs over the past 9 years to check for rupture to my Allergen textured silicone implants which are 22 years old. A small amount of fluid (8 x 40 mm) has been detected to posterior of the left implant which has mildly increased in the 3 year period between most recent MRI and one performed in 2018. Radiologist report states that the location of the fluid means it is not amenable to image guided aspiration. No ruptures or other symptoms with implants. Should I have implants removed?

Kenneth Hughes, MD · Answer

Allergan has stated that BIOCELL® saline-filled and silicone-filled TEXTURED breast implants and tissue expanders will no longer be distributed or sold in any market where they are currently available. Allergan has stressed that surgeons should no longer implant new BIOCELL® TEXTURED breast implants and tissue expanders and unused products should be returned to Allergan. However, the FDA is not recommending removal or replacement of Biocell TEXTURED breast implants in asymptomatic patients. Discuss with your board certified PS.

Gary M. Horndeski, MD · Answer

Yes, your implants need to be removed. The concern is BIA-ALCL, which is associated with fluid production. The surgeon will need consent for possible removal of the capsules as well as implants and you will most not likely want to re-implant at that time.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Daniel Barrett, MD · Answer

Dear sunny2021,
I recommend my patients to replace implants after 10 years in order to avoid complications. Since your implants are 22 years old, I recommend you to remove them. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will et more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Connie Hiers, MD, FACS · Answer

Textured implants may often have some fluid since the implant can tear away from the capsule with activities. This is actually fairly common. However, I would suggest meeting with a board certified plastic surgeon and discussing this finding.

Camille Cash, MD · Answer

As you have noticed an increase in the fluid amount over time, combined with the age of the implants, it would be logical to have them exchanged.  I encourage you to visit with a board certified plastic surgeon for a consultation.  Bring along your MRI results so your surgeon can make recommendations based on the reported information.

MRI shows a small amount of fluid behind 22 year old textured silicone implants. Should implants be removed?

Answers (5)