The FDA recommends screening for silicone breast implants to look for silent rupture. The screening is not mandatory, but recommended.
So what do they recommend? Whether you have cosmetic breast augmentation or breast cancer reconstruction, you should screen for implant rupture. This does not replace your imaging for breast cancer screening and mammograms. This is only for silicone gel implants.
- For asymptomatic patients, the first ultrasound or MRI should be
done at 5-6 years postop, then every 2-3 years thereafter. - For symptomatic patients or patients with ultrasound results for rupture at any time, an MRI is recommended.
Do you need to do screening for saline implants?
No. Saline implants if they are leaking are evident, as they will decrease in size.
My thoughts?
Many breast implant ruptures are evident, as the breast will change- shape will change, they will harden, they will look or feel different. I have had a handful of patients where that did not happen- the breast looked and felt normal, but a possible rupture was detected on mammogram, and then confirmed with MRI. I have also had patients who had “likely rupture” on MRI, who had intact implants.
Your body makes a capsule around the implant- think of the capsule as a balloon of scar tissue. If your implant leaks, it is almost always caught within the capsule. The current silicone gel implants have a higher degree of cohesiveness, and that also helps prevent gel bleed or spread. Think of the gel as being like jello, not liquid.
But I have had patients with silent ruptures. So I would heed this advice. When you are out 5-6 years, do an ultrasound or MRI.