Answers
"I received breast implants in 1988. The breast implants used on me were subsequently taken off the market, were said to increase the risk of cancer due to their polyurethane outer coating used to prevent capsulation. Currently I am having pain on one side near the nipple area and do not know if it is nerve related pain or a problem with leakage. The implants are uneven and the texture feels funny on that side. I am having a problem finding anyone that wants to get involved with removing these and replacing them. In the past I have had annual mammograms which are painful and I question their accuracy. I am presently afraid to have a mammogram for I fear that the implants are ruptured and will further rupture during the procedure. Do you recommend ultrasound to detect rupture? I would greatly appreciate it if you could offer some suggestions and possibly referral information for a surgeon in the Baltimore area."
— Answered by
Laurie A. Casas, MD
Glenview , IL
First I would like to ease your mind regarding the association between polyurethane coated silicone implants and cancer. To date there is NO evidence to support this claim. Secondly, there is no perfect test to detect leakage, and unfortunately ultrasound is not that helpful. An experienced Radiologist at a Breast Center can help you decide whether any of the available tests are really cost effective (e.g. MRI of the breast can cost as much as $2,000 yet not always give you the answer). I suggest to all patients with silicone implants over 15 years old that have symptoms of pain, and who have also experienced a change in breast shape, that they consider surgery. The breast pocket can be explored with the plan to remove the implant if broken, and replace it if you desire. As far as the details of exactly how this should be performed, including specifics regarding anesthesia, incisions, capsulectomy or capsulotomy and replacement in the same or different position (above or below the muscle) – this should be decided after a careful examination of you and all the facts regarding your previous surgery.
We can give you the names of three of our surgeons in the Baltimore area, Navin Singh , MD , Alexander M. Guba, Jr., MD, and Paul N. Manson, MD. All are Board Certified by the American Board of Plastic Surgery.
