Removing Ruptured Implants
By Dr. Killeen, published on January 20, 2021
How and why do you remove ruptured implants?
Today I had the pleasure of ridding a lovely patient of 40 year old silicone implants. With older, ruptured implants like this it is so helpful to remove them En Bloc (implant and capsule in one piece) to prevent the silicone from getting everywhere. Check out the white calcification inside the capsule. They form from the chronic inflammation caused from the broken implant. This is why we recommend exchanging your implants on a schedule to prevent this!
Q: Up to what age would you keep switching out implants?
This is a great question, until the patient is no longer healthy enough to tolerate the operation and the risk is not worth it. People can safely have surgery into their 70’s and 80’s! Each generation of implants are sturdier and last longer. Hopefully in the future we will have implants that last 30+ years.
Q: When would you recommend switching out non problematic implants if they are 10 year old gel implants? When I had the initial surgery the recommendation was every 10 years. Do you still recommend this?
That is the official recommendation from the FDA. I think it’s reasonable to stretch it out to 15 in the right patient.
Q: I’m getting rid of my implants and having a DIEP flap procedure so I don’t have to keep replacing mine.
That is a great option!
Q: What if you had them for 11yrs? Do you recommend exchanging them?
If they are silicone it’s time to start thinking about it. Not an emergency but a good idea for the next few years.
Q: Do you recommend exchanging 15 year old saline implants that are still in good shape? Any harm to leaving them in for now?
No harm leaving saline in if you are happy with them! Risk of rupture will still be there, but saline are less problematic if they rupture in you. Also, you will know because your breast will shrink!
Q: This is the one thing that haunts me post DMX (double mastectomy). Options for me were either implants or go flat, as I wasn’t a candidate for diep flap.
These are the older implants and were very old. The current generation managed properly are safe and a great option!
Q: I would love to know should you remove implants that they are intact and they are on a breast reconstruction patient after a bioleteral mastectomy? Should my insurance pay for this?
If they are silicone yes, we still recommend changing them out to prevent rupture and it’s related complications. Also, if you are a reconstruction patient they typically do pay for it!
Q: What type of chronic inflammation can this cause?
Chronic inflammation around the implant. The internal silicone gel is irritating to the body. Chronic inflammation of all sorts can lead to calcium deposits like this regardless of where it is in the body.
Q: What if one breast is lower then the other one? Is that a problem? Complication?
It can be implant malposition or contracture, but also can be just how that particular patient is made.