Written by: Stuart A. Linder, M.D., F.A.C.S.
Beverly Hills, Board Certified Plastic Surgeon
Today I operated on a breast revision patient who had 28-year-old ruptured silicone Dow Corning implants. On MRI, it was determined that the patient had both extra and intracapsular rupture of the implant. As a result, these were probably chronic ruptured implants for many, many years. What has happened is the implants have ruptured and the silicone has now bled and leaked through the capsule into the breast tissue itself. This can then lead to spread to the lymphatic system, including the axillary lymph nodes and any other lymphatic system in the body.
The first picture shows the ruptured silicone implant material being carefully pulled out of the right breast through an inframammary approach, but the shell is no longer attached and there is simply silicone gel in a viscous form.
The next photograph actually shows the ruptured silicone implants.
Note, there is a patch on the posterior portion of the implant associated with Dow Corning implants.
Notice also that the shell has disintegrated on one more than the other; however, the silicone has bled through it leading to this hard, white, plaque tissue referred to as calcified granulomas and silicone mastitis.
The next photograph shows the entire capsule that has been exenterated from both breast cavities, including the posterior chest wall directly on the muscle.
Note, the appearance of the capsule is extraordinarily thick, it’s white, it’s hard, it’s chalk-like and it actually crushes and crumbles just like chalk. This patient underwent complete open periprosthetic capsulectomy, removal of ruptured silicone implant and implant material of Dow Corning, placed in 1981, and then had reconstruction with style 20, 280 cc Allergan Natrelle gel implants through the inframammary approach.
The entire cavities were cleaned out completely and reconstructed. Please note, the patient should not wait 28 to 30 years to have her silicone implants replaced. Actually, between 10 and 15 years is a reasonable period of time to expect to have implant exchange. However, MRIs performed every three years will indicate whether the silicone implants are intact or not.Δ TOP
Stuart. A. Linder, M.D., F.A.C.S. is a Beverly Hills plastic and reconstructive surgeon specializing in breast augmentation, liposuction, tummy tuck, and more.
Dr. Linder is certified by the American Society of Plastic and Reconstructive Surgeons and is a diplomate of the American Board of Plastic Surgery (ABPS).