48-Year-Old Ruptured Dow Corning Implants
Yesterday, I had the privilege of removing Dow Corning silicone implants that were now 48 years old; in fact, several years older than me. As expected, this was an extremely time-consuming and difficult surgery, as the silicone implant material had calcified over the last 35 years due to disintegration of the shall of the implant bag. The calcifications were so hard and the shell was so thick, possibly up to a quarter of an inch thick, that boney rongeurs were required in order to pull out the tissue and capsule. The electrocautery Bovie and scalpel were unusable on this capsule due to the massive calcifications and hardening. Exenteration of the capsule took a significant amount of time. Removal of the patches on the posterior wall was quite tedious as well, in order to prevent a pneumothorax. The silicone implant material can be seen by the photograph as liquid silicone gel with minimal evidence of remaining silicone shell. The size of the implants was absolutely impossible to determine due to the loss of integrity of all shell and demarkation. This operation required aggressive exenteration of the capsule, thickened, hardened shell, removal of silicone material, irrigation and Bacitracin antibiotics and reconstruction using style 45 silicone Allergan gel implants with a formal mastopexy breast lift in order to retighten the skin. Her breasts are now soft and supple and hopefully the patient will live another 75 years with excellent results.