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What would be best - to remove a leaking implant (implanted 20 years ago) and replace it, or just have both implants removed?

Q:

My daughter had breast implants put in over 20 years ago.  Her mammogram showed a mass in her right breast which she was told was leakage from her implant and that she needed it removed.  Is it better to have it removed and replaced or have both implants removed?  She would rather have the implants removed but is unsure of what her breasts will look like afterwards. Also, money is a problem as she is on state help and the insurance she has through the state, will not cover this.

A:

With limited funds the simplest, easiest and most cost effective approach most likely would be the removal of the breast implants in your daughter's case.

Gary R. Culbertson, MD, FACS

A:

The real question after being told a breast implant is leaking, is are there any symptoms? Just because the gel is outside the breast implant shell, does not mean that it is dangerous. Usually the body will encapsulate the gel and wall it off from the rest of the body. If there are absolutely no symptoms and the leakage was discovered only on mammogram, the most cost effective thing to do is to simply follow her and reevaluate her if any symptoms develop. If she does decide to have the implants removed, she needs a capsulectomy also to remove the breast implants and the scar tissue that formed around them. Unless she has excellent skin elasticity and relatively small implants, the breasts will usually sag after the implants are removed. 

A:

Based on your information simple removal of implants may be best. Most women who choose to have implants removed are happy that they have done it and are not distressed by the change in their breast size and shape. Most feel more comfortable without their implants. She can always choose to have implants placed later if she chooses.

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