The issue is to have a discussion with your patient about what you've found and lay out the options for them. There is not general consensus that even in the presence of a known leaking implant it is necessarily an indication for removal. So options are presented to women about observation; the likelihood of there really being a leak, even if it's been identified potentially on a mammogram, MRI, or ultrasound; and the options for removal and replacement. They are laid out, and then the procedure is scheduled for the patient if it's required.
I try to triage my patients as best as I can. If a woman has a very noticeable leak of an implant and it looks like it may have come out from the capsule that forms around the implant, I try to move surgery and get that woman in as quickly as possible to deal with it. It's essentially done on a case-by-case basis.