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BREAST IMPLANT SCREENING

Silicone Rupture Detection

Advanced Patient Imaging offers MRI screening to detect silicone gel ruptures in breast implants. MRI is the most effective way to detect silent rupture of a silicone gel-filled breast implant. The FDA and implant manufacturers recommend that women with silicone gel-filled breast implants undergo MRI screening three years after they receive a new implant and every two years after that for early detection of a silent rupture.

What Is A Ruptured Breast Implant?

A breast implant rupture occurs when a breast implant breaks. When a saline breast implant ruptures, it is usually noticeable right away because the saline tends to leak quickly and the implant will deflate causing the affected breast to change in size and shape.  The leaking saline solution will be absorbed by the body.  MRI is not necessary to detect saline ruptures.

 

When silicone breast implant ruptures occur, the silicone tends to leak very slowly. A rupture to silicone breast implants may not be noticeable for years.  Ruptures that occur without any symptoms are known as “silent ruptures.” 

 

Over time, silicone gel may escape from the scar tissue capsule around the implant and migrate away from the breast. This can cause lumps to form in the breast, chest wall, armpit, arm, or abdomen. 

 

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Breast Implant Rupture Rates

Breast implant ruptures generally do not occur until years after the initial procedure. One study published April 2014 in Plastic & Reconstructive Surgery looked at rupture rates in 383 breast cancer patients who received breast reconstruction at Memorial Sloan-Kettering Cancer Center. (see chart below)

Silicone Breast Implant Rupture Rates
 After ImplantationRupture Rate MRI Screening Recommendation*
  Year 3 0% At Your Discretion
 Year 5 0% At Your Discretion
  Year 7 2.3% Yes
  Year 10 15.1% Yes

*If you are NOT experiencing any breast or implant-related problems.

Does this mean that MRI screening of silicone gel breast implants should never be performed?  Not at all, for the following reasons:

  1. This study strictly included women with no symptoms.  Women with pain, implant deformity, new breast lumps, etc. were excluded from this study. If you have silicone gel implants and are experiencing problems with them, MRI is the most effective way at detecting silicone gel breast implant ruptures.

  2. This study only offers conclusive data for 3-year and 5-year MRI screening. Preliminary results suggest a rupture rate of 2.3% at 7 years and 15.1% at 10 years. Silicone gel implants can and do rupture; they just tend not to rupture in the first 5 years.

  3. The FDA-approved manufacturers of silicone gel implants (Allergan, Mentor, and Sientra) typically offer a 10-year or limited lifetime warranty on their products. The warranties these companies offer vary but typically provide a new implant at no cost and will pay most or all of the surgical, anesthesia, and facility costs to replace a ruptured silicone gel implant, provided the rupture is documented.   

Based on the information above, women with silicone gel breast implants should strongly consider MRI evaluation before the tenth anniversary of their breast surgery. There is a 15.1% chance that you will have a ruptured implant (based on the 2014 study) and a 100% chance that the manufacturer will cover most or all of the costs of implant replacement surgery.

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Early detection of a rupture is essential to protect the investment made to enhance your body. 

Cause Of Ruptures

 

Symptoms Of Rupture

Most women have no signs or symptoms when a silicone breast implant ruptures. However, some women may experience:

In cases where there are no symptoms or signs, it is called a “silent rupture”.  In this case, you would not know that your implant has broken.

Intra or Extra Capsular

Breast implant ruptures can be either an intra-capsular or extra-capsular.

An intra-capsular rupture occurs when the shell of the implant ruptures but the fibrous capsule formed by the breast remain intact.  Since silicone gel leaks slowly, it is difficult to detect on mammograms or ultrasound.  An intra-capsular rupture is almost impossible to detect on mammography.  Intra-capsular ruptures are best seen on MRI. 

An extra-capsular rupture can lead to a change in the implant contour and may be detected by a clinical examination, mammogram or ultrasound.  An extra-capsular rupture implies an intra-capsular rupture as well. 

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Image above demonstrates an extra-capsular and intra-capsular rupture. 

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