Date: Tue, 1 Feb 2000 13:52:43 EST

The indications for removal of silicone breast implants are fairly straightforward. If a lady has had augmentation mammoplasty using silicone implants and she has had no change in the appearance of her breasts and no pain or discomfort that has recently appeared, then it is a safe bet that the implants are intact. If, however, a lady has had silicone implants used and there is an increase in the firmness of her breasts that has developed over a period of months, if she has noticed an asymmetry develop, if there has been

an increase in pain, or if she has noticed abnormal lumps where she had not seen lumps previously, then all of these changes in the breasts could be associated with recent silicone implant rupture. Under these circumstances, if the history is fairly straightforward and is supported by the appropriate physical findings, then one could assume that the implant has ruptured and it should be removed and replaced by a normal saline implant. For a plastic surgeon who is familiar with breast augmentation and the various sequelae that can follow this procedure, both with silicone implants and with normal saline implants, the history and findings are quite easily put together. If, however, a physician who has less experience with this concern is faced with this question from a patient, then they can resort to various procedures such as a mammogram or an ultrasonogram, which may assist in the diagnosis of the problem. From my point of view, I get the best information from a very selective history which is supported by a physical examination of the breasts.

Wayne R. Perron, MD, FRCSC

Plastic Surgeon

Related articles:

Cooper, C, Dennison, E. Do silicone breast implants cause connective tissue disease? Comment: BMJ. 316(7129):403-4, 1998 Feb 7. BMJ. 316(7129):417-22, 1998 Feb 7.

Brown, SL, Silverman, BG, Berg, WA. Rupture of silicone-gel breast implants: causes, sequelae, and diagnosis. Lancet. 350(9090):1531-7, 1997 Nov 22.

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