Silicone Implants over 20 Years Old

What should you do if you have Silicone Gel Implants Older than 20 years???

If you have silicone gel implants older than 20 years then you should consult with a Plastic Surgeon regarding the integrity of your implants and to discuss your options. Board certified plastic surgeon Dr. Suzanne Quardt provides breast revision to patients in Newport Beach and surrounding areas.

What are the concerns of having silicone gel implants older than 20 years?

The biggest issue is to ensure that your older implants are not leaking or ruptured.  Silicone gel implants manufactured over 20 years ago are NOT the same type of implants made today.

How are today’s silicone gel implants different from ones made over 20 years ago?

Several improvements in the quality of silicone gel implants have been made over the past 20 years- these include things such as making the outer shell thicker and thus more resistant to rupture, as well as making the silicone gel inside more “cohesive” so that the gel doesn’t “run out” in the same way that older types of implant gels can.  Today’s silicone gel implants are 4th to 6th Generation silicone gel implants- much better quality and way improved and thus “NOT the same as your Grandma’s implants”!

I have implants older than 20 years- I’ve gotten several mammograms and they haven’t shown any implant abnormalities- should I still get my old implants checked/evaluated?

The answer is yes- Mammogram is a good diagnostic tool to detect early breast cancers, however it is NOT a very specific tool to detect implant ruptures until the ruptures become so very obvious that they show up on mammography.  Better signs are any changes in your breasts such as hardening or firming of your breasts around old implants (also known as “Capsular Contracture”) or severe “flattening” of your breasts where your implant used to sit that may represent a ruptured implant that is losing, or has lost its integrity.  If you have ANY pain in your breasts- then you should absolutely have your implants checked- however many women with encapsulated and ruptured implants have no pain.  There is also something known as a “silent rupture” where the implant ruptures without any clinical pain or signs- the diagnostic test for this is MRI (Magnetic Resonance Imaging) and this test is the most sensitive and specific for ruling out an implant rupture.

Is it dangerous to have an old breast implant?

If your old breast implants are saline, then the answer is no- you only need to replace your old saline implants if you are having a problem.  If the saline implant ruptures, then the saline will get re-absorbed by your body and poses no serious threat.

However, if your silicone gel implants are ruptured- you may experience either an “intra-capsular” or an “extra-capsular” rupture.  Intra-capsular ruptures mean that the implant has ruptured, however the silicone material is being contained within the scar tissue or capsule that has formed around the implant and should hopefully then not travel farther unless left unchecked.  An “extra-capsular” rupture means that the silicone material has migrated to outside of the breast capsule- and then the silicone has the potential to either make its way to the surface/skin and “extrude” through the skin, or travel to the local axillary lymph nodes.  If you have ruptured silicone gel implants, you should have them removed immediately and all implant manufacturers currently recommend removal of any ruptured silicone gel implants.

Can old silicone implants seem grossly intact yet still be leaking?

The answer is yes.  Sometimes earlier on than gross rupture, a silicone gel implant’s outer shell can degrade over time, and the silicone inside can then slowly make its way through the degraded shell- this is called “silicone bleed”- where the silicone “bleeds” through the compromised shell and the body can then react to this exposed silicone.  Oftentimes there is a clinical sign that this has occurred- such as firmness or hardening of the breast tissue around the implant with silicone bleed- this is called a capsular contracture.  However, sometimes there is no clinical evidence that an old implant is leaking.

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