Breast Implant Replacement


Over the past 20 years, plastic surgeons have treated large numbers of women who have had leaking silicone breast implants for their resulting complications. The suspected relationship between gel implants and arthritic type diseases has not been supported by studies in large numbers of patients. Leakage of gel from the breast implants commonly results in hardening of the breast, (CONTRACTURE), but not always (See discussion on CAPSULAR CONTRACTURE of breast implants).

Some women who have ruptured gel breast implants may still have soft breasts, but that is the exception. If the gel remains inside the normal scar tissue capsule the gel does not usually produce any side effects other than the hardening. If on the other hand the scar tissue capsule is somehow damaged, the leaking gel may escape from the scar tissue pocket and infiltrate the breast tissue. This will usually cause a significant foreign body response producing the formation of hard lumps, which may not be removable without also removing large amounts of breast tissue.

One of the misconceptions about breast implants adhered to in the past was that gel implants were superior to saline filled implants because saline implants frequently leaked and gels did not. It became apparent to your plastic surgeon early in his career that this belief was flawed and that saline implants only seemed to leak far more often than gels. When saline implants leak the sterile saline is safely absorbed by the woman’s body and the breast becomes smaller making it obvious that the implant shell had broken. Leaking saline implants are therefore recognized 100% of the time. That is not true of gel implants because unless the gel escapes from the scar tissue capsule, showing up as lumps in the breast, the patient is totally unaware that the implant has leaked as it cannot be detected by examination nor even a mammogram. The point is that there are many women with ruptured gel implants who are totally unaware of the situation, whereas when a saline implant ruptures it is always obvious.

Although your plastic surgeon does not charge for initial cosmetic consultations, there is a fee for consultations regarding complications from previous breast surgeries such as the replacement of gel breast implants.

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