Ruptured Breast Implants Q&A for the St. Louis Area

Posted: February 27, 2012 in Board Certified Plastic Surgeon Breast Implant Information Ruptured Breast Implants

Ruptured Breast Implant Question and Answer Information

How do I know if my implant has broken? That is a important question. 50% of silicone gel implants from the 1980s have been found to have ruptured by 20 years. ARuptured implants should be removed.

If a saline filled implant breaks then the saline will re absorbed by the body and there should be an obvious change in volume. AIn theory there could be a very small hole with a very gradual leak and a slow change in volume over time. AThat is less likely. ABut with observation for a period of time it should become noticeable. AIf a silicone gel implant breasts and the silicone gets outside the capsule [the scar around the implant] then the body may react to it and form a lump that is palpable or can be seen on mammography. AIf there is rupture but the silicone stays within the capsule, which is the most common situation, then it can be difficult tot detect. ANeither physical examination nor mammography is a reliable method to detect intracapsular rupture. MRI is the best method but it is not 100% accurate; there can be false positives or false negatives.

Will my insurance cover this? AIf the implants were placed for reconstruction, i.e. following mastectomy for breast cancer, then insurers will cover treatment of complications. AIf the original procedure was cosmetic, i.e. elective augmentation mammoplasty, then some insurers may cover removal with documented rupture while others will not. AThe plastic surgeon has to write to them asking for preauthorization in order to find the answer. AIf the original procedure was cosmetic no insurers will cover placement of new implants. AThe warranty on the implants may provide a replacement implant.

Do the implants needs to be replaced? AIf there has been no change then the same rationale for improvement in body contouring is still there. AIf there has been a significant change in medical status or age, or if there has been a change in weight with change in breast volume, then some women may elect to do no reconstruction, or to do mastopexy, or to change the size of the implant. it depends upon the individual.

Does the implant on the opposite side also need to be replaced? AIf the implants are not very old then no change may be needed. AWhile if the implants are significantly older then it makes sense to also replace the other implant. AIf the size or type of implant were to be changed, then both sides would need to be done for symmetry.

Can this be done through the same scar? AIt may depend upon what exactly needs to be done. ARemoving all the silicone material may require a larger opening leaving a longer scar. AIt may be necessary to do this through an infra-mammary approach even if the original procedure was done some other way.

What about the PIP implants made with industrial grade silicone that have been in the news recently? Those implants were never released for use in the United States.

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