Silicone gel implants were first used for cosmetic breast surgery in the early 1970's. Saline-filled implants were added in the late seventies or early eighties. Over time gel implants tend to leak certainly by the twenty year mark. It is natural for women with these implants to wonder what they should do with them. As you might imagine, there is no one answer for all women. It depends upon the current condition of the implants and the breasts in which they reside as well as the woman's preferences. Not all patients need do anything except regular breast cancer surveillance - regular mammograms, physical exams, and possibly breast MRIs (especially for silicone gel implants.) For ladies considering at additional surgery, below we will introduce a few options:

(1) Simple Removal - For women without too much droop or distortion of the breasts, simple removal is the most basic option. It involves less surgery, but can leave the breast distorted and/or droopy depending upon the degree of sag and the amount of scar that the woman's body deposited around those implants. This is not always the most attractive option. Your health insurance is likely to cover this, but exclusions for insurance companies are quite individual. Take this up with your insurance company directly for your best information..

(2) Removal of Implants and Scar Capsules - This is a little more involved than (1), but results in less long term scarring and distortion as the scar around the implants is also removed. It might also make a breast more amenable to mammographic screening for breast cancer as it removes more silicone (that within the scar capsules themselves).

(3) - (1) or (2) Along With Implant Exchange - This puts back the volume of the previous breast implants with either saline or a silicone gel-filled implants. Patients who have had silicone gel tend to feel a difference with saline-filled implants.

(4) - (3) Along With Breast Lift - For women with droopy breasts or those wishing to reduce breast implant volume, an additional breast lift can "take up the slack" making a more youthful-appearing breast with less sag.

(5) - (3) Along With Breast Reduction - For women that might have gained weight since their implant placement, breast volume can be so large that reduction even after implant removal can be in order.

About Secondary Silicone Breast Implant Surgery

Secondary silicone breast implant surgery is exactly that, a revision by design. Your results from this kind of surgery vary dependent not only upon your surgeon's skill, but also the degree of distortion and scarring and your capacity to heal. Minor additional procedures are not universal, but are common to improve the result. The incidence of these procedures is probably 20%. Also, for those patients looking to combine insurance-covered surgery with cosmetic procedures, I advise a word of caution. Watch out for the secondary denial by your insurance company. Just be careful.