HEYER-SCHULTE IMPLANT REMOVAL
This case example is of a patient with a 42-year-old ruptured Heyer-Schulte silicone gel implant placed back in the late 1960s. This is a 78-year-old White female who presents with severe capsulitis, mastitis, ruptured silicone implants and symptoms of possible rheumatoid arthritis. She was referred by her rheumatologist for removal of her ruptured silicone implant, implant material with breast mastopexy lift, reconstruction and drainage.
Intraoperative photo of the ruptured implant shows a posterior patch notable on a complete dissolved shell with loose, smooth silicone gelatinous material. The Heyer-Schulte implants were the first United States manufactured saline implants back in 1968. Heyer-Schulte implants initially manufactured the polyurethane silicone gel prosthesis with an internal Y-shape baffle called the Natural Y Prosthesis. Heyer-Schulte later introduced multiple single lumen gel implants in the early 70s. These implants notably had a thinner shell. These implants were removed with complete dissolving of the majority of the shell with calcifications within the capsule and scar tissue formation throughout the breast. The Heyer-Schulte implants have had data on shell thickness and gel characteristics that were not initially available by the company. Dorne reported weights of average silicone gel molecular weight to be 83,500, significantly higher than the modern Silastic II silicone gels of 55,000 molecular weight. It is very rare to find patients with Heyer-Schulte silicone implants. These implants on most patients have been removed and replaced decades ago or the patients are now deceased.
These are the oldest silicone implants in my person practice of 16 years that I have had the chance to remove. The patient is now postoperative three weeks and the implants have been removed with a full breast lift and drains removed. Postoperative photos will be present in a following blog.