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Breast Augmentation

Removal/replace?

MarieP kankakee, IL
3 months ago

Five months ago I learned that one of my 32-year old implants is ruptured and calcified. I’ve been told numerous times by my doc that I have very dense breast but had been instructed to have annual mammograms (even upon my concern for rupture). At this time all I want is a reputable board-certified surgeon that would at least remove them. He’s Sending me for another Mam to see if worse. Should I?


Debra Johnson, MD Sacramento, CA
3 months ago
SURGEON PROFILE PROFILE

When a breast implant is placed, your body forms a scar, called the capsule, all the way around the implant, kind of like an envelope around a letter. In some women, that scar will shrink, which balls up the implant and makes it feel firmer than normal. If this firmness persists for several years, the capsule will start to calcify, making it even firmer and like an eggshell. Before operating on breasts, we like to be assured there is no breast cancer, so we will often have a woman get a mammogram pre-operatively if she is due for one. If your mammograms are painful or difficult to read, then an MRI could be considered. An MRI can check the breast tissue for abnormalities, and it can then be dialed to check implant integrity. If your implants are ruptured, your insurance will often pay to have them removed. They won't pay for replacement implants or a breast lift, as that is considered cosmetic. Consult an ASPS member surgeon, use the Find-A-Surgeon tool to locate members nearby.

Tracy McCall, MD Waukesha, WI
3 months ago

Mammograms are important and you should be getting them.

You know that you have a ruptured implant, so it is reasonable to remove both at this point. You would want the hard capsule removed as well. Replacing the implants is up to you.

There are many board certified surgeons not too far away from you. You can use this site to find them. I am in southeast Wisconsin; a bit of a drive for you but I do these cases.

Rick Rosen, MD Norwalk, CT
3 months ago

At this point with a diagnosed ruptured 32 year old implant with calcifications, I personally would not repeat the mammogram, I would remove the implants via an enbloc procedure. Replacing them is your decision.

To repeat a compressive test I do not feel is indicated as your breasts have been evaluated just 5 months ago.

Karol Gutowski, MD, FACS Glenview, IL
3 months ago

Based on the information you provided, you seem to have a reasonable request to remove them. Feel free to contact me for a consultation if your surgeon will not address this issue.

Jon Ver Halen, MD Colleyville, TX
3 months ago
SURGEON PROFILE PROFILE

Hello and thank you for your excellent question. Based on your description, I think that it is likely unnecessary to repeat the mammogram and go straight to implant removal. 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!

Edward Domanskis, MD Newport Beach, CA
3 months ago

If you are planning to take your implants out then there should be no need to get another xray. You should definitely consider having an en bloc capsulectomy(www.enbloccapsulectomy.com). These I do in my office in California or Miami. You would need to be there for a few days only.

Dr. Edward Jonas Domanskis is Certified by the American Board of Plastic Surgery

Newport Beach, San Francisco,Miami, EU, Anguilla

Assistant Clinical Professor of SurgeryWOS-Plastic,University of California (Irvine)

Orange County’s Physician of Excellence/America’s Top Physicians/Top Doctors

Plastic Surgery- 2005-2018

President,American Society of Bariatric Plastic Surgeons

Organoderm Skin care/ScaRxTape

Once you know the implant is ruptured, removal is recommended, especially if they are 32 years old. If you haven't had a mammogram in a year, you should get one before surgery. Removal if the implant and capsule definitely require expertise. Start your search on this site to ensure a board certified plastic surgeon.

Enriquillo Clime Rivera, MD Santo Domingo - Dominican Republic
3 months ago

Hi, the scar tissue around the implant (capsule) will keep the implant covered, but i think that if the implant its rupture it should be removed, as you can understand it most be done on both sides, so seek the attention of a certified plastic surgeon and everything should be fine

Curtis Wong, MD Redding, CA
2 months ago

If you know your implant is ruptured and your capsule calcified, I personally would not waste any more time with additional studies IF you are accepting of the potential risk that there could be a concerning lesion in your breast and that you will manage it later when the post-op mammogram/ultrasound is done with there is no obscuration from your capsule and implant. And the procedure must include a capsulectomy...

Nelson Castillo, MD Atlanta, GA
2 months ago

Thank you for sharing your excellent question. At this point based on your implant details I would focus on having them removed, as well as the surrounding calcified capsule to afford you a softer, more natural, appearance and feel to your tissues. Hope this helps.

Joseph Daw, MD Oak Lawn, IL
2 months ago
SURGEON PROFILE PROFILE

With a diagnosed ruptured implant as well as calcification of surrounding scar tissue (the capsule), removal of both is appropriate. This is outpatient surgery. A mammogram is not necessary prior to the surgery as long as you have been receiving annual mammograms and there otherwise have been no other concerns regarding your breast tissue. I would be happy to see you in consultation.

Paul Parker, MD Paramus, NJ
2 months ago
SURGEON PROFILE PROFILE

It's not clear to me if a mammogram done 5 months ago allowed the diagnosis of a ruptured implant. If a mammogram was done 5 months ago, should not need another one now. If not, it makes sense to have a mammogram prior to implant removal.

Ergun Kocak, MD Gahanna, OH
2 months ago
SURGEON PROFILE PROFILE

With a ruptured implant it would be best to move forward with total en bloc capsulectomy and removal of the implants. Depending on breast size and the amount of the nipple ptosis that is present, you may consider other simultaneous procedures such as breast lift or fat grafting. We specialize in this procedure and perform it routinely on patients from all over the country. We are generally able to accept insurance and have developed a process to make it easy for patients to travel in for surgery. Feel free to reach out to us with any questions or to set up a virtual consultation.

Wendell Perry, MD Hollywood, FL
2 months ago
SURGEON PROFILE PROFILE

Removing ruptured implants that have been in place for 32 years is becoming a less common procedure in the sense that the type implants used 32 years ago have mostly all been removed by now. The last time I removed an implant from your generation of implant was probably 10 or 15 years ago. The difference is the gel and the implant is not cohesive and it's more like an oil that a gummy bear. So removing the implant is about cleaning this oily silicone out.

You can remove the implant and replace it or you can remove the implant and not replace it. The problem with not replacing implant is you will have to do a breast lift and creating cleavage in the upper pole is very difficult without an implant. There is an option that's available now with the new procedure of fat transfer to the breast. So now you could harvest your fat with liposuction and use that fact to create the cleavage in upper pole that's lost when you remove the implant.




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