An adapted suction technique to aid removal of ruptured silicone implants.

Implant rupture is a common complication of breast implant surgery. Removal of silicone gel after breast implant rupture can be difficult and time-consuming. In the medical literature, a few other methods attempt to solve this challenge. We propose a simple and efficient technique to maximize its removal by suction. This method bypasses the problem, given the disadvantages of silicone's high viscosity. Moreover, the necessary equipment is inexpensive and readily available in any operating room.

Introduction

Implant rupture is a common complication of breast implant surgery. Removal of silicone gel after breast implant rupture can be difficult and time-consuming. We propose a simple and efficient adapted technique to maximize its removal by suction.

Method

Suction of silicone is difficult due to its viscosity. Using a wide bore solid 60 ml plastic syringe (BD, Becton, Dickinson and Company Limited, Ireland) attached to a liposuction machine (PSI-TEC III Aspiration System, Mentor, CA 93111 USA) will overcome this viscosity even in cohesive gel implants. Following removal of the plunger, the ‘open' end of syringe is inserted into the capsule via a very small capsulotomy. Suction tubing is connected to the other end of the syringe. The machine is switched on to a pressure of 400–600 mbar and the silicone is extracted (see video).

Discussion

Complete silicone gel removal is recommended to prevent complications such as inflammation, capsular contraction and silicone nodules from developing. Two other authors have proposed different vacuum-assisted techniques to help silicone gel removal after implant rupture. In 2006, O'Neill and Taylor reported the use of a 1 liter saline bottle connected to a ‘Baldwin spike adaptor,' which is connected to suction tubing. In 2009, Bell et al. recommended the use of a 60 ml Toomey syringe connected to suction tubing in order to bluntly grasp the capsule during en bloc capsular removal and reduce intracapsular silicone volume in order to prevent accidental silicone extravasation during removal. We propose this adapted technique to rapidly remove all silicone from the implant capsule.