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There is one additional breast screening recommendation by the FDA for patients with silicone breast implants. At the date of this blog entry, the FDA recommends MRI screening every 2 years for patients with silicone gel breast implants. The purpose for getting an MRI every 2 years is to detect implant shell rupture. Detection of breast implant shell rupture is challenging in patients with silicone breast implants.

Saline breast implants will typically change size when the shell ruptures. Silicone may or may not change size when ruptured, therefore the term “silent rupture.” This means that the breast implant is ruptured but is not causing any symptoms, so the patient would not be aware the rupture has occurred. Most silicone breast implant ruptures are undetectable clinically. Thus far there is no evidence detected between silicone gel implants and connective tissue disease, breast cancer (with one exception; see our blog on the link between implants and cancer), or reproduction. Silicone breast implant rupture, however, can potentially cause problems. Possible problems with silicone breast implant rupture include change in size, change in shape, change in sensation, lumps, pain, and migration of free silicone. Rupture of silicone breast implants may increase the chance of problematic breast capsule formation. Because of these potential problems, it is reasonable to recommend replacement of silicone breast implants when it is determined they have ruptured.

The cost of MRI of the breasts every 2 years adds significant cost to the silicone breast implant procedure. Health insurance may not cover this cost in patients that get silicone breast implants for cosmetic reasons. Over the life of the silicone breast implants, the cost of the screening MRI may cost more than the breast augmentation procedure itself. This is a very important factor to consider when choosing silicone breast implants. A screening MRI for shell rupture is not recommended for saline breast implants at this time.

Patients that get breast implants are no different than any other female patients in that all should receive screening for breast cancer. Breast screening is recommended for patients without breast implants and patients with breast implants.