What Almost Every Breast Augmentation Patient Forgets

When silicone breast implants became available again to cosmetic patients in 2006, the FDA recommended that implants be monitored periodically with a non-contrast MRI. The recommendation has been for patients with silicone gel implants to get a non-contrast (meaning no intravenous contrast dye is necessary) MRI scan three years after surgery and every two years thereafter. The purpose is to look at the integrity of the implant shell: Any evidence of a rupture or tear is an indication for implant removal or exchange. It is true that current 5th generation silicone implants don’t “leak” like old ones did, as their gel is more uniform and cohesive (gummy bear consistency), nevertheless out of an abundance of caution changing or removing a compromised implant is standard of care.

“MRI continues to be an effective method of detecting silent rupture of silicone gel-filled breast implants. If you have silicone gel-filled breast implants, the FDA recommends that you receive MRI screening for silent rupture 3 years after receiving your implant and every 2 years after that.”

https://www.fda.gov/medicaldevices/productsandmedicalprocedures/implantsandprosthetics/breastimplants/ucm063871.htm

The vast majority of women getting breast implants in my practice, and most plastic surgeons’ practices, get silicone gel implants and the vast majority of these women don’t get MRIs on schedule. Explaining the recommendation for MRI breast implant surveillance is a part of the consult I have with patients getting silicone breast implants, but frankly most patients forget about it. Some remember, but choose not to get the MRI. Some may have had routine mammograms and think they must be equivalent to an MRI, but for “looking” at the implants, they’re not.

For cosmetic breast implants, the cost of the MRI is an out of pocket expense and in Santa Barbara the Women’s Imaging Center charges a very reasonable fee. If you’ve had silicone breast implants for more than 3 years and you’ve forgotten or neglected to get an MRI, contact us or your primary care physician to order your non-contrast breast MRI for silicone implant surveillance.

Author
Douglas J. Mackenzie, MD

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