The silicone breast implants has led many women to explore this option. We have had many questions on our discussion board about the proper long term care for silicone breast implants. This article is a high level overview of the main issue women have been asking about detecting potential ruptures in silicone breast implants. This is not meant to worry anyone or make anyone think silicone breast implants are unsafe. The FDA would not have approved them if it felt they were unsafe. Rather this article is intended to help consumers understand the evolving nature of the long term care recommendations regarding silicone breast implants.
About Detecting Ruptures in Silicone Breast Implants
The silicone breast implants used in breast augmentation or breast reconstruction today generally do not leak the way saline implants leak. The silicone gel is what is known as “cohesive”, meaning that it is thick and does not move freely the way water (saline) will move. If a silicone breast implant ruptures, there is unlikely to be any apparent change in observable breast size because the fluid does not leak out. Therefore, detection is very difficult if not impossible through observation and examination of the breast. Even your plastic surgeon probably can’t detect a rupture in today’s cohesive silicone breast implants. However, silicone implant ruptures are detectible through other methods.
Screening for Ruptures in Silicone Breast Implants
Silicone breast implant ruptures may not be detectable through self examination or observation, but they can be detected with proper screening through the use of an MRI. The FDA issued guidelines for recommended MRI screening when it approved silicone breast implants. The FDA states, The best method of screening is currently MRI at a center with a breast coil, with a magnet of at least 1.5 Tesla. The MRI should be read by a radiologist who is familiar with looking for implant rupture.
While that information sounds very technical and daunting, rest assured that the surgeon who performs your breast augmentation should be able to recommend a good radiologist who can perform the MRI screening for you. You won’t need to worry about asking different radiologists about magnet size! In no case should the MRI screenings be seen as a replacement for your regular follow up visits with your plastic surgeon. Your plastic surgeon will look for other issues in addition to ruptures, so please, please go to your regular follow ups!
Frequency of MRI Screening – Silicone Breast Implants
The FDA initially recommended that patients begin MRI screening of silicone implants 3 years after implant surgery and then every two years, thereafter. This recommendation is only a guideline and has not been updated by the FDA as the study results continue to evolve. Many breast surgeons believe that an MRI is not needed after 3 years given the low failure rate of silicone breast implants after 3 years. If the studies show that failure rates remain low for many years, it may not be necessary to have an MRI for many years.
Silicone breast implants are as viable a choice today as saline. Your personal preferences and your plastic surgeon’s recommendations and guidance will help you to determine which choice is right for you. Make sure to have regular follow up visits with your surgeon so that he can guide you with respect to long term care of your breast implants. As the Mentor and Allergan studies evolve, so will long term care recommendations, including the timing of any recommended MRI screenings.