American Society of Plastic Surgeons
For Medical Professionals
 
Muriel Mumu
one year ago
Answered

Silicone in lymph nodes

Ruptured Implants with silicone in Lymph Nodes. I have a hard time finding a plastic surgeon who can also remove my swollen and painful lymph nodes. It looks like I will need 2 surgeries

Would you know what are the risks of having silicone in the lymphnodes?

Will the pain and swelling go away on its own?

Is there a way to extract the silicone without removing the lymphnodes?

Procedure: Breast Implant Removal
Location: Crossfield, AB - Canada

Replies 4

Alfred Antonetti
ASPS Surgeon

If you saw a board certified or eligible ABPS physician you should have had all of these questions answered. If not then you need to see one in person for an exam and review of your history. Most of the time the silicone in the nodes will not cause any problem and they need not to be removed. It is recommended that you have the implants removed along with a capsulectomy most likely. The removal of the lymph nodes is something different and the determination of if this needs to be done or not depends on your history and physical exam of the surgeon. Plastic surgeons do not remove lymph nodes usually as this is a lot of times done by a general surgeon. If needed, a lot of surgeons would prefer to do it in stages, removal of the implants, re-evaluation and then the lymph nodes. You should definitely have the implants removed. This is just my opinion and some other surgeon may have a different one. It's OK. Visit your surgeon and both of you decide what is best for you. Good Luck.

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Robert Oliver
ASPS Surgeon

Curious as to how you’ve been diagnosed with this

Silicone migration of ruptured implants made within the last 30yrs+ would be extroidnarily rare. The gel is not very liquid and tends to stay in a clump, so there’s not much potential to migrate. The rare times we see this, most of the implants are From the 1970’s or early 80’s before the implant designs matured. Any plastic surgeon that does breast implant surgery should be able to remove the implant and any extracapsular silicone gel (including an enlarged node) without much

Difficulty

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Tanongsak Panyawirunroj
ASPS Int. Surgeon
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Please ask your doctor for the diagnosis again because silicone migration of ruptures implants to the lympnode is very rare and seem curious. For the recommended procedure you need revise breast implants with capsulectomy and if you have lympnode problem doctor will remove them in the same time.

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Omar Beidas
ASPS Surgeon

I have seen this a few times and there is no consensus treatment. The way I have treated these patients is similar to what's been said here: remove the implants and as much extra-capsular silicone as safely possible. I generally let the patient wait a few months to see if the swelling/pain subsides. In only 1 case have I gone back and removed an enlarged, painful lymph node as the rest improved without surgery. You may get different opinions as this is a pretty rare circumstance. Hope this helps!

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