Implant Rupture – Implant rupture is a complication that is seen in a relatively small percentage of patients. If a saline implant ruptures, the salt water typically leaks out, the breast deflates and the patient would return for implant removal and replacement. With silicone gel filled implants, rupture may be harder to detect. Because the body forms a membranous layer of scar tissue which totally ensheathes the implant (capsule), when a silicone gel filled implant ruptures, the silicone often remains within the confines of the capsule (intracapsular rupture). This is something that is very difficult to diagnose on physical examination and even hard to see on mammography.
The best radiologic examination is MRI, which has a very high degree of accuracy in detecting implant rupture. With some of the older style breast implants where the silicone gel was less high cross linked, there is a greater chance that the silicone that leaks out of the envelope can spread into the breast tissue and even adjacent structures such as the muscles of the chest wall and the soft tissues of the upper abdomen. In these cases, the diagnosis is very easy to make. Correction of ruptured silicone implants is a routine part of Dr. Handel’s Santa Barbara plastic surgery practice. In all cases, the ruptured implant will be removed in its entirety and any silicone that has leaked will be cleaned out. Typically, the scar tissue capsule is removed to make certain that all microscopic deposits of silicone have been eradicated, and then a new implant is inserted to reconstruct the breast. The details of implant rupture, of course, vary a great deal from one patient to another. Therefore, Dr. Handel will design a “customized” treatment plan to account for all of the issues associated with any particular clinical scenario.
Obviously, when it comes to secondary or “breast revision” surgery, the particular operation for any given patient is specifically tailored to her needs. Dr. Handel and his staff will design a procedure suited to treat as many of your concerns as possible, and the surgical procedure will be executed from start to completion in a manner that assures the best chance of a successful outcome and the least risk of persistent problems or additional complications. Sometimes, breast revision surgery is covered by health insurance policies; in most cases, health insurance will not cover the cost of breast revision (particularly if it was a result of an operation that was originally cosmetic). In most cases, the surgery is performed on an outpatient basis in an ambulatory surgical facility under general anesthesia, and a board certified physician-anesthesiologist administers the anesthetic.
Dr. Handel is the co-editor of a major new book on breast revision surgery that was released in early 2014. This book is the standard “reference book” for other plastic surgeons throughout the United States and around the world who want to learn the most advanced techniques in corrective secondary breast surgery.