Implants are 28 yrs old. Recent mammogram shows leakage on one side yesterday, never showed before. Need advice of next steps as to how soon to remove, replace and by whom.. want the best surgeon experienced in this.
Try to get any old records about your implants, such as the type, size etc.
You should see a board certified plastic surgeon and a member of the American Society of Plastic Surgeons.
After a history, physical exam and any necessary additional studies, you should engage in a discussion about the risks, benefits and alternatives for your condition.
It’s not a medical emergency however it should be addressed in a timely fashion.
Hi Barbara, though not an emergent situation, all leaked/ruptured implants should be removed and replaced. Depending on what filling material, the leaked out substance can harm surrounding tissue by forming granulomas or nodules (from chronic local inflammation) or cause further tightness and pain from a condition we called capsule contracture. If your filling material is saline then quickly you will see contour deformity from substantial deflation. So I would urge you to find a board certified plastic surgeon to examine you, look at your films, and potentially schedule a time for replacement.
Implants are man made devices so they are not meant to last forever, it's a very common condition that plastic surgeons deal with all the time. I am sure you will find good plastic surgeons in your area who are capable to handle this problem.
William Lao, MD
New York Board Certified Plastic Surgeon
28 yrs is a long time for implants to be in place. Now with the leak, you should get them replaced/exchanged. With revision surgery and implants that are this old, its important to identify any hardening, calcifications of the scar tissue, any leakage of the silicone outside of the scar tissue, the relative position of the implants, the size, shape, symmetry and other aspects and match the revision surgery to the expectation that you have. Many decisions have to be made, of course after a detailed consultation, proper evaluation, assessment and discussion of the appropriate strategy. Some times it can be a simple operations to exchange and other can be more involved. It is not urgent but should be done in a timely manner to avoid further leakage and problems.
Please visit with a board certified plastic surgeon from ASPS.
You should have bilateral capsulectomy and removal of implants. That gets rid of all the old silicone. Depending on how your breasts look and are sizing now, maybe simply replacing the implants, or if your breasts have dropped, a breast lift with or without implants. Use the Find A Surgeon link to locate a board-certified ASPS member surgeon near you to discuss options. Insurance will pay for broken implant removal, although replacement and breastlifting would be considered “cosmetic” and on your dime. As another surgeon said, not an emergency, but should be taken care of in a timely manner. Best of luck.
If your mammograms suspects a leakage then you may want to go ahead and get an MRI to confirm this. It would be nice if you had an idea of what size implant you have as well to plan out your procedure. Your best to go see a plastic surgeon and be properly evaluated in person so that a surgical plan can be formulated for you. Best of luck.
The standard method of implant "clean-up" after a leaking silicone implant has been diagnosed is implant removal with capsulectomy. Capsulectomy removes the scar tissue around the implant that has been exposed to the silicone gel. Also, you will want to plan whether you want a new implant - what kind, shape and size- or not. (Some women elect to have the implants removed, and not replaced.)
Best to discuss with your local board-certified plastic surgeon.
Thank you for sharing your question. A plastic surgeon well-versed with breast procedures will be able to help you remove your implants, surrounding scar tissue, and place new implants in a single setting. Use the “find a surgeon” feature on this website to find local surgeons.
Hello and thank you for your excellent question. 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!