American Society of Plastic Surgeons
For Medical Professionals
5 years ago

Ruptured Silicone Gel Implant

Hello, would a ruptured silicone gel implant cause a skin ulcer that will not heal if it has been ruptured long enough? (Also a large lump under the sore). The implant has been pushed up almost to my collar bone because of this lump. So as you can imagine there is pain with all of this. Any input is appreciated so I know where to go from here. Thank you.

Oh and the implants are 5 years old.

Procedure: Breast Augmentation
Location: Boston, MA

Replies 9

Alex Lechtman
ASPS Surgeon

Hi Kelsey. It would be rare to have a rupture at 5 years. It does sound like you have a hard scar around your implant (capsular contracture). Please see your surgeon ASAP to check. Make sure that they are certified by the American Board of Plastic Surgery so that they are trained to take care of this problem. Good luck.

Larry Leverett
ASPS Surgeon

Good Morning Kelsey21:

It is unusual for implants to rupture at only 5 years. However, there are other etiologies to consider. If there is a hard palpable mass underneath a "sore", you may have a pending extrusion. The tissue is not healed properly, perhaps because of a previous undrained hematoma (blood clot), rarely because of an accumulation of serous fluid (seroma), or even because of smoking related ischemia in breast lift procedures, or rarely because of an infection. I may be something as simple as a capsular contracture causing distortion, odd shaped and an implant that is abnormally too high. Therefore, I urge you to get evaluated by a Board Certified Plastic Surgeon ASAP. He/she should be able to help you get it straightened out.

Katerina Gallus
ASPS Surgeon
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Hi Kelsey. Thank you for your question. There are several possibilities to include a capsular contracture or a rupture or possibly a breast mass that is unrelated to your implants. I recommend that you schedule an appointment ASAP with a board certified plastic surgeon for an exam and further testing if necessary. At a minimum have the ulcer evaluated by a primary care physician. Good luck.

Best regards,

Dr. Katerina Gallus MD FACS

William Lao
ASPS Surgeon
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Dear Ms. Kelsey,

What you are describing could very well be an implant rupture. When a silicone implant ruptures, the silicone filling inside can migrate anywhere around the original pocket. Most of the time it remains in the capsule that formed around the original implant but other times it can go outside the capsule and to more distant part of the chest (like the collar bone area you mentioned). The best thing to do now is to remove all the implant and ruptured material, wash out the area well and then depending on how clean the pocket is whether to replace it at the same time or in a later setting.

You can also see some cases I uploaded in my profile for secondary breast implant exchange.

best regards,

William Lao, MD

Board Certified Plastic Surgeon

Manhattan, New York

Sara Dickie
ASPS Surgeon
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Hello Kelsey,

Thank you for posting your question. This must be a very concerning problem for you and I'm glad you are asking this question to the ASPS members. What you describe may be a rupture, but as mentioned earlier, could be other more serious things like a tumor or an abscess. A mass (lump) that has pushed the implant so far up your chest needs to be evaluated by a physician as soon as possible. I would strongly encourage you to either see a board certified plastic surgeon or at the very least your primary care doctor.

Daniel Allan

You should have a breast MRI. This is the gold standard for determining if a silicon gel implant has ruptured. Unfortunately, it will also cost you some gold for the study. If the implant is ruptured, it should be removed-this is a medical, not cosmetic issue (whether insurance will cover it is another issue altogether).

Jon Ver Halen

Dear Kelsey,

Hello and thank you for your excellent question. Your presentation is unusual, but not impossible. I suggest that you seen a face-to-face evaluation with a plastic surgeon ASAP. It is best to answer your question during a face-to-face evaluation, when you can discuss your goals and expectations for the procedure, and you can have a physical examination to evaluate for that procedure. I recommend that you find a board-certified, or board-eligible plastic surgeon with whom you are comfortable. Be sure to have all of your questions answered during a face-to-face meeting with your surgeon, and review before and after pictures of similar patients whom have had this procedure. If you have any questions, call our office for assistance. Good luck!

Jose Luis Valero
ASPS Int. Surgeon

Dear Kelsey:

Here the question is if what you have it is a benign or malignant condition, If it is really a ruptured implant or something else, And certainly it is not OK for you to experience those pains, so, please, find a Certified Plastic Surgeon in your area, and ask for a consultation, if your original surgeon is not available.

Nelson Castillo

Thank you for sharing your question and I am sorry to hear of your discomfort. Unfortunately without photographs or an in-person examination it is difficult to offer definite advice. After five years a more common cause of an upwardly displaced implant would be a capsular contracture. This not only makes the implant feel firmer, but can cause rib and chest pain to the patient. I would make an appointment to see your surgeon in consultation to discuss.


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