Can deflated saline implants be safely left inside the breast once all fluid has been drained?

Question

I had saline implants 350cc in June 2014. I am 64. By Dec. 2014 the left breast had encapsulated and sat much higher on chest wall. PA 'fixed' the left implant in Dec. 2014. For about 6 months both looked much the same However, now the left breast is again hard and I'm experiencing shoulder and back pain. The PA said he could deflate the implants and leave it inside the breast. Have you ever heard of this method, will it work and not cause health problems or breast shape distortion?

Raffy Karamanoukian, MD, FACS · Answer

Removal of breast implants, intact or ruptured, may have positive implications if patients are symptomatic. A constellation of symptoms associated with breast implant illness, and autoimmune disease are considered when treating patients who have breast implants and are concerned about foreign body reaction. In our office, we begin this journey with a consideration of symptoms and exclusion of obvious autoimmune problems. In many of our patients, en bloc removal of breast implants with capsulectomy is important and beneficial. Further clinical evidence about breast implant illness is evolving and will continue to guide treatment. I would suggest removal if there is a possibility of foreign body reaction.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Ira H. Rex III, MD · Answer

There is no evidence to suggest leaving deflated breast implants in place has significant risks. These implants are easy to remove under local anesthesia and it seems wise to remove them when convenient.

Ross Blagg, MD · Answer

Hi MoxeyB,I'm sorry you're having these symptoms. Deflating the implants may help some with the pain if it is due to weight. Your body will absorb the saline. This technique is often employed when patients plan to have their saline implants removed. Deflating them in the office gives the patient and surgeon an opportunity to see how much the skin will retract after deflation and can help guide the amount of skin removal needed for a breast lift. However, it sounds as though your symptoms are likely due to a combination of capsular contracture and possibly weight. Leaving the deflated implants in place is likely not medically dangerous, but you will likely have the best relief of symptoms by having the implants and the surrounding capsule removed. Please make sure you have a face-to-face consult with a board certified plastic surgeon so that he/she can examine you before you make your decision. Best wishes, Ross Blagg, M.D.

Payman Danielpour, MD, FACS · Answer

Yes I have heard of this technique but I dont do it.  I prefer to remove the implant if it is deflated.

William J. Hedden, MD · Answer

If the idea is to leave them in for a short period of time while your tissue contracts around the implant to later have either an exchange or lift then the answer is it will probably be ok. But I have seen three case where doctors left them in for years deflated and the patients eventually developed so much scar tissue that it became very painful which then lead them to come in and have them removed. So typically we would take them out.

Michael J. Brown, MD · Answer

Hi,

Thanks for posting your question. I am happy to try and help you. It is
important to remember that a board certified plastic surgeon will be your best
resource when it comes to an accurate assessment of your situation, and
concerns.

Having said that, leaving the breast implants in after deflation is possible and may be reasonable to allow for evaluation of the skin, breast shape and life impact of having the breast implants removed. Once it is determined that the patient is happy without the implants. I recommend simply removing the implants. This can be done in the office and at a reasonable expense.

Best wishes,

Dr. Michael J. Brown
Northern Virginia Plastic Surgeon

Julio Clavijo-Alvarez, MD, MPH, FACS · Answer

I am sorry that you are having concerns about your procedure
and thanks for sharing your question. I can appreciate your
concern.

One of the principles in plastic surgery is to treat the
cause of the problems not the consequences. In your case the problem is the
capsule that formed around your implant. The fact that you are having pain, it
is a major indication to remove it for medical reasons (possibly covered by
insurance) removing the fluid from your implants not only will deform your
breast, but not treat the current problem that you are complaining of.
Finally, make sure that you have a
consultation with a board certified plastic surgeon that specializes in breast
revisions.

Wishing you the best in your journey

Mennen T. Gallas, MD · Answer

I appreciate you posting your question. It is not customary nor recommended to leave your deflated implants unless the plan is to remove them within a relatively short amount of time. My recommendation is to have them deflated and removed all in the same surgery. While I don't perform this surgery under local, there are some board certified plastic surgeons who do. I would suggest having at least 1 or 2 more consultation with board certified plastic surgeons before moving forward with the surgery. Best of luck!

Mark A. Brzezienski, MS, MD, FACS · Answer

Whenever I purposefully deflate a saline implant , it is with the intent that the patient is going to have them removed.A deflated saline implant should be considered a failed mechanical devise, and all manufacturers would recommend its removal.A deflated saline implant is not an "Emergency", but indicating that you should keep the devise in your body in a damaged form, indefinitely, is just not the standard of care.There is, interestingly, not a large population of folks who keep deflated implants in that has been scientifically studied over time.  But...It just strikes me as bad idea.

Kamran Khoobehi, MD · Answer

I am sorry that you having problems with your implants.You can have your saline implants aspirated and left in place till you ready for removal. If the plan is to leave them in place  permanently, I would not recommend it.

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