Ruptured Implant Porous Shell Leakage


The video below shows a patient who recently had implants removed that were 12 years old and had microscopic leakage of silicone gel through the shell of the implant. However, there was no specific loss of integrity of the shell and no rupture of the implant itself. The MRI did not detect any evidence of a ruptured implant. There was no linguine sign identifiable as well. In any case, the patient had scar tissue formation with calcified granulomas and pain in bilateral breast and desired to have open capsulectomy, circumferential open capsulotomy and removal of silicone gel implant material calcifications with replacement. The video indicates that the patient had specifically smooth low profile silicone gel implant.

Upon removing it there was sticky silicone material identifiable circumferentially along the entire capsule as well as the entire surface of the implant. This indicates that the older silicone gel implants have thinner shells and they do have microscopic translocation of silicone through porous leakage. The silicone gel implants can rupture either through a direct tear within the shell losing integrity and having loose silicone then spread throughout the breast pocket from intracapsular through the shell of the capsule to an extracapsular migration into the lymph nodes or the lymphatic system. On the other hand, small microscopic pores within the shell over time may secrete tiny capsules of microscopic silicone beads which with time can also calcify and form calcifications and severe scar tissue formation. Patients with silicone implants over 10 years old should consider explantation with reconstruction with new implants due to the microscopic translocation of silicone leakage.

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