A ^Retired Plastic Surgeon's Notebook

Why are some breast implants as hard as rocks?

Calcified breast implant capsules can make a breast rock hard.


Calcified breast implant capsule surrounding an 32 year old ruptured silicone gel breast implant.


32 year old ruptured silicone gel breast implant after opening the calcified capsule.

I recently removed  32 year old breast implants from a lovely lady in her mid 60’s.  She was embarrassed how the implants felt when she hugged someone.  “It’s like having two rocks in my bra.”  Here is the reason her breasts felt like rocks.

The photo on the top shows the implant surrounded by the implant capsule.  The photo on the bottom shows the implant (which was ruptured) and the capsule after the capsule was opened.  The yellow gooey stuff is the implant material.  The white structure under the implant is the inside of the capsule.  The white stuff is calcium.  Yes, calcium – the same stuff that makes your bones nice and hard.  The calcium deposits are hard and brittle and can make an encapsulated implant literally rock hard.  Nasty capsules such as this are most common in old silicone gel implants but I have also seen cases like this in saline breast implants.

These photos also illustrate another important point with removal of ruptured breast implants.  In this case, I was able to remove the ruptured implant and the capsule in one tidy piece and there was no spillage of the silicone into the breast.  I love it when I can do this.  It is not always possible but I always try.   When it is not possible and I have to remove the ruptured implant before removing the entire capsule, there is often some spillage but I do my best to minimize it and clean up any spilled silicone prior to closing the breast.

And yet another important point should be obvious from this photo.  Should the capsule be removed along with the implant?  YES!  It would be crazy to leave that nasty capsule behind.  It would shrivel up into a hard mass, be palpable and possibly visible and would look really, really funky on mammogram.   I always go after thick and nasty capsules.  If removing the capsule puts a vital structure at risk, I may leave some of it behind but I try to get as much out as possible.  Removal of the capsule is the hard part of the case but it is worth the effort and time to leave behind a nice, clean breast.

Oh, and one more point.  This were really old implants.  The implants available currently are much tougher and have thicker gel and are less likely to rupture.   The problem illustrated with this case are less likely to occur with the new generation of implants.

And check out my video where I remove a calcified capsule from a saline implant.

Thanks for reading!  Dr. Lisa Lynn Sowder


Category: Breast Implant Removal, Breast Implants | Tags: , , , , , , , , , ,

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