Q: Dr. Eppley, I had breast implants placed 12 years ago. One of my implants is encapsulated. That breast nipple is leaking an oily green substance. Can this be a leak?
A: Since your breast implants were originally placed in 2000, you have saline breast implants if they were placed solely for cosmetic reasons. The only silicone breast implants that were placed at that time were those for breast reconstructions. When saline breast implants leak, they deflate and exude water which is not an oily substance. In addition, every breast implant has a surrounding layer of scar (capsule) which for some implants become abnormally thick and have varying degrees of hardness. (capsular contracture) This capsule serves as a very firm barrier that even silicone gel can not escape unless a capsular tear occurs. That is a long description to say that what is coming out of nipple most likely has nothing to do with your underlying breast implant per se. I suspect that the hard capsular contracture may be pushing against the breast duct/glands causing these secretions.
Dr. Barry Eppley Indianapolis, Indiana
Q : I had saline implants done three years ago in 2007. I had some left breast pain last night and woke up this morning with my left breast almost completely flat. I was mortified. How did this happen? I need to get my implant replaced as soon as possible. How quickly can we get this done?
A: Failure of a breast implant is a lifetime risk for anyone that undergoes breast augmentation. While everyone thinks it just happens to someone else, the statistics say that the risk is 1% per year of implantation. Failure of most breast implants occur spontaneously, meaning that there is no specific reason why or there is nothing that the patient has specifically done to cause it. It just happens from the fatigue of the implant folding back and forth.
Saline breast implants fail in a particularly dramatic fashion, known as deflation. Once the implant shell develops a hole or tear, the saline fluid comes rushing out and the breast goes partially or completely flat. This is one of the few cosmetic ‘emergencies’ that exist from a patient’s perspective.
If this should happen, contact your plastic surgeon immediately. Arrangements should be made to have replacement surgery within a few days. In my Indianapolis plastic surgery practice, we make every effort to get a patient’s deflated implant replaced no later than the next day if possible. If you have a copy of your implant size and serial numbers that is very helpful to get an exact size replacement. In the past ten years, most plastic surgeons provide a plastic card to the patient after surgery that has the lot and serial numbers from the manufacturer. This information is also very useful to find out what your warranty replacement is from the manufacturer, if the implants are not too old. (greater than 10 years)
The good news is that the breast implant replacement surgery is nothing like the original surgery. The pocket has already been made so the surgery is simpler and is comparatively painless from the initial breast augmentation surgery.
Dr. Barry Eppley