Patient Ruptured Silicone Implants Case Study
Dow Corning ruptured silicone gel implants with acute right breast hematoma. The case shows a very interesting patient, a marathon runner, who had her silicone gel implants placed over 26 years ago. Her preoperative photograph shows that she has severe superior retroposition of her implant. The patient noted pain over the last week on the right breast after running a 12-mile marathon. It is notable that her implants are over a quarter of a century old, Dow Corning implants, and even without diagnostic testing, it is obvious that the ruptured breast implants are bilateral with silicone calcified granulomas and a massive amount of silicone mastitis. However, the superior elevation of the implant on the right is indicative of a possible tear in the capsule leading to either hematoma or seroma. It was noted in the operating room that the patient had immediately an acute hematoma with a tear of the inframammary fold muscle causing bleeding, mixed with the ruptured silicone gel material leading to this brownish type of silicone goop.
Notice the difference in color on the left ruptured silicone implant material, which is a yellow clear color versus the dark brown rent of the hematoma mixed with the calcifications and loose silicone gel material of the right.
In general, implants should be replaced every 10 years as instructed with the FDA. MRI's are excellent in determining the integrity of the shell of the bags. However, in cases such as this where the implants are over 25 years old, it is usually evident that the implants have ruptured and the shells no longer have significant integrity to maintain the silicone within the bag and intracapsular rupture can now spread through the capsule, become extra capsular and then spread to lymphatic structures, including lymph nodes and the axilla.
This is a very interesting case, especially with the right breast acute hematoma, indicating that even 25 years later that a hematoma can occur around the breast implant associated with severe trauma to the muscle. Her surgery required bilateral open explantation of silicone implant materials, calcifications removed, open capsulectomies, irrigation of pockets and hemostasis of the right breast bleeding vessels along the inframammary fold and subsequently reconstruction with a 500 cc style 20 silicone gel implant.
Stuart A. Linder, M.D., F.A.C.S. is a Beverly Hills plastic and reconstructive surgeon specializing in breast augmentation, liposuction, tummy tuck, and more.
Dr. Linder is certified by the American Society of Plastic and Reconstructive Surgeons and is a diplomate of the American Board of Plastic Surgery.
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Skin Deep Magazine
"Reasons For Reoperation:
Breast Revision Surgery"
Contributing Writer:
Dr. Stuart A. Linder,
Board Certified Plastic Surgeon
January 2006
Case Study of Ruptured Silicone Implants