To those women who either have breast implants or are considering breast augmentation, the acronym MRI could be very relevant. Since all breast implants will eventually fail, the detection of silicone implant failure is much more difficult than in saline. Since disruption of a silicone implant shell is silent (no deflation) it can only be detected by radiographic assessment. Magnetic resonance imaging (MRI) has been the gold standard to detect loss of shell integrity in silicone implants.
In addition to detecting silicone implant rupture when one is concerned or having symptoms, women that have had silicone breast augmentation since 2006 have been recommended by the FDA to have a checkup MRI every three years after implantation. (no thought was given however to whom is going to pay for these studies, thus compliance is probably less than 1%) Besides expense, MRIs are loud and require a patient to be in a confined space for a period of time.
The solution to the use of conventional MRIs is high resolution ultrasound. (HRUS) This is a fast and convenient alternative to MRI for determining the status of breast implants. High resolution ultrasound is painless and is very similar to fetal–maternal ultrasound screening with which many women are very familiar. Studies have shown that HRUS has a near 100% accuracy at detecting silicone breast implant rupture as seen in the February 2012 issue of the Aesthetic Surgery Journal with an article entitled ‘High-Resolution Ultrasound in the Detection of Silicone Gel Breast Implant Shell Failure: Background, In Vitro Studies, and Early Clinical Results’. This landmark study concluded that the ultrasound approach is equivalent to MRI in terms of visualization of implant rupture.
For those women who suspect or have symptoms of silicone breast implant rupture, HRUS is a good alternative to an MRI evaluation.
Dr. Barry Eppley
Indianapolis, Indiana