Breast Implant Removal

No. In spite of recent discussions surrounding breast implants and illness, there is no clear evidence that breast implants cause autoimmune disease.

There are many potential causes of cellulitis, or an infection involving the skin. These include surgery, minor trauma (cuts or scrapes), blocked pores, acne, ingrown hairs or other primary skin conditions. Implants themselves are not typically the cause of the cellulitis. Cellulitis of the breast following implant surgery may be a sign of a more serious infection and should be evaluated immediately by your doctor.

This is extremely rare. There have been cases of severe, delayed capsular contracture years after implantation that progress to cause breast pain. This can be treated by treating the contracture.

This is extremely rare.

The only health problem that has been definitively linked to breast implants is breast implant associated anaplastic large cell lymphoma (BIA-ALCL). This extremely rare form of lymphoma has been associated with certain types of breast implants with a textured outer surface. Many of these implants have been recalled as the link between the implants and the disease is further investigated. Fortunately, most cases of BIA-ALCL are easy to diagnose and cure.

The incidence of capsular contracture varies based on many factors, including the incision used, implant type and implant position and surgical technique. Recent reports cite an overall incidence of 0% to 15% over 13 years.

It is important that you have a sense of your natural volume, so that you are aware of your breast size following implant removal. Also, speak with your plastic surgeon about the possible need for a lift if removing your implants is likely to leave you with an unsatisfactory shape.

It is very difficult to quantify the magnitude of breast implant illness as there are no established criteria for the diagnosis. There are certainly many women with breast implants and signs and symptoms of illness. The challenge is identifying which of these patients, and which of the symptoms, may be related to breast implants. Studies meant to clearly demonstrate a link between breast implants and breast implant illness have been inconclusive.

Regular self breast examination should be done by every woman, with or without implants, every month. Implants should be checked by a physician and/or imaging if any change is detected. Manufacturers recommend regular MRI’s to evaluate for \u201csilent leak,\u201d and this should be discussed with your surgeon.

No. Until we have a better understanding as to whether there is any link between breast implants and specific disease, insurance companies do not participate in the treatment of breast implant illness. Women insurance companies may consider breast implant removal medically necessary in some circumstances, such as BIA-ALCL, but they will not cover the cost of breast implant removal for autoimmune disease, connective tissue disorders or other systemic illness.

No. There is little or no danger associated with removal of breast implants.

Textured implants manufactured by Allergan have been voluntarily recalled while their association with BIA-ALCL is investigated. These are considered macro-textured devices. Micro-textured breast implants are still available.

Capsular contracture typically presents with a breast that feels firm. If it progresses, it can cause visible distortion of the breast.

Implants to not \u201cpop\u201d like a balloon. Over time, the outer shell of the implant can develop a small hole. In the case of silicone gel implants, this may not produce any detectable change. If a saline implant leaks, there is typically a noticeable change in volume.

If the implants are intact, and are not causing capsular contracture or any other problems, they do not need to be replaced. Leaking implants should be replaced if there are no health contraindications. If a patient has a ruptured silicone implant, but is not a suitable candidate for surgery, there is no evidence that the device poses a direct health threat.

There have been cases of capsular contracture that have resolved spontaneously without treatment.

Yes. We have seen implants last for 40 years or more.

There is no scientific evidence that any implant, silicone or saline, causes autoimmune disease.

The only potentially fatal condition known to be caused by breast implants is breast implant associated anaplastic large cell lymphoma (BIA-ALCL). While there have been deaths from this extremely rare disease, most were cases that were not diagnosed at initial presentation. Now that the signs and symptoms of the disease are better understood, it is almost always diagnosed at a stage when it is still easily cureable.

Yes. Breast implants can be removed surgically.

In some cases, particularly with saline implants, you may notice a change in the appearance of your breast(s). The best study for detecting a leaking breast implant is an MRI.

BIA-ALCL most commonly presents several years after augmentation with textured implants as a sudden swelling of one or both breasts (i.e. late seroma). Diagnosis can be made by sampling the fluid around the implant and sending it for testing in a lab.

This is a very difficult question to answer. In cases where a patient recovers from illness without having her implants removed, the illness was not related to her implants. In some cases, removal of implants can lead to immediate improvement in symptoms, although precise explanation of why is not clear. This is important because it is possible that a patient who believes she has BII and has her implants surgically removed, may continue to have the same symptoms after surgery.

Firmness of the breast or breasts is typically the first sign of capsular contracture.

This varies, but typically ranges from $4000 to $5000 for implant removal.

This is highly individual as no clear guidelines have been established for the diagnosis. Reported symptoms include chronic pain, fatigue, anxiety, GI problems, memory loss, depression, sleep disturbances, and many others.

Silicone toxicity more accurately describes a condition related to the injection of liquid silicone. Systemic exposure to silicone from even a leaking silicone breast implant is extremely low. In fact, studies suggest that women get more silicone exposure from deoderants and shampoos than from silicone breast implants.

Thus far, only implants with a textured outer surface have been linked to lymphoma (BIA-ALCL). There has been no link between smooth surfaced implants and lymphoma.

If the soft tissue support in the lower portion of the breast is not adequate to support the implant, the implant can settle into a low position, compromising the shape and causing the nipple to look too high. This is called \u201cbottoming out,\u201d and can usually be corrected by providing better support in the lower pole of the breast.

This varies by implant type, and nature of the surgery (cosmetic vs reconstructive vs revision). Currently in the U.S. implant rupture rates range from 1% to 18% at 10 years.

Implants should be replaced if they are ruptured or if there is capsular contracture or if the patient desires a change in volume.