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Can a Mammogram Rupture a Silicone Gel Implant?

I have silicone gel implants and I'm worried about future mammograms causing silent ruptures. My implants will be 16 years-old by the time I get my 1st mammogram. What is the likelihood of a mammogram rupturing an implant? I know that MRI's are the best option for silicone gel breast implants, but I doubt my insurance will cover this. Plus, I don't want my insurance to know I have breast implants because I'm scared they'll drop me. I'm considering switching to saline implants prior to needing mammograms because at least I can tell if it ruptured or not. Advice/suggestions appreciated.

Doctor Answers (12)

Mammograms and ruptured breast implants

+3

The mammogram probably cannot rupture an intact implant but it can release the scar envelope around an implant and if the implant is already ruptured, the gel can then escape into the tissues.

I once took care of a patient on whom exactly this happened. She had old gel implants placed years before. They were ruptured but contained within the capsule. They were below the muscle. The mammogram tore the capsule and the pressure of the exam injected the gel up through the pec muscle into the breast tissue. This was all captured live on the xrays.

An MRI can't do this so it might be the first thing to do.


Seattle Plastic Surgeon
5.0 out of 5 stars 48 reviews

Don't get rid of your silicone breast implants just yet! Options for rupture detection

+2

I share your concerns with my patients. Howver, recently there has been some research that has shown that high resolution ultrasound may be a very effective tool for diagnosing silicone breast implant rupture.

Another option is that many MRI facilities are willing to charge significantly less for cash prepay. Whereas an MRI may run up to $3000 at a hospital facility, many free standing centers are willing to perform the servce for around $400. Call around and ask!

I hope that this helps

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 44 reviews

Can a mammogram rupture a silicone gel implant?

+1
Hello!  Thank you for your question!   It is highly unlikely for a mammogram to rupture a breast implant.  It is known that women are more in tune with their breasts and more diligent with examination and feeling/knowing the contour of her breasts, thus able to identify any abnormality sooner, with breast procedures.  Imaging studies of the breasts are similar to imaging without breast implants and cancers are not hidden either by the presence of breast implants.  It is true that with breast implants do obscure a portion of the breast during imaging studies, but with the Eklund displacement views, which should be done when having mammograms with breast implants, there is minimal change.  I typically recommend a preoperative mammogram prior to breast surgery, since the architecture of the breast will change.  You should remain proactive with your monthly self examination, annual clinical examination, and mammograms beginning at age 40 (unless family history, as directed by the Radiological Society), and annually thereafter.  If there is anything concerning on mammogram, other imaging modalities would be utilized, including ultrasound and/or MRI.  Best wishes!  Hope that this helps!

Lewis Albert Andres, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 12 reviews

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Highly unlikely for an implant be ruptured by a mammogram

+1

It is highly unlikely that a mammogram would ever rupture an intact implant.    With the new form of breast implants produced after 2009 there is little chance of the implant gel material migrating since the gel is more cohesive than it was prior to this time.  Therefore it may be difficult to tell if it is ruptured since the implant tends to keep its original shape. The problem is non an emergency.  You would need some type of diagnostic study to determine if it was actually ruptured such as a  mammogram, MRI or ultrasound.

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 9 reviews

Mammography after breast Implants

+1

Mammography can still be performed with breast implants in place. Mammography technicians are trained to use specialized techniques for women with breast implants that help to image the breast tissue around the curved surface of the implants. Be sure to let the mammography provider know that you have breast implants when you schedule your mammogram.

It is not possible to obtain a mammogram by imaging through the implants, only around them. Breast implants therefore potentially do reduce a radiologist's ability to visualize breast tissue completely. This is more of a concern with implants placed immediately behind the breast ('sub-mammary', aka 'sub-glandular' position), so for that reason the sub-pectoral position is strongly preferred.

There is no conclusive evidence which shows that women with breast implants are diagnosed with breast cancer at a later stage than women without implants - which one would expect if breast implants actually delayed the detection of breast cancer. Likewise, women with breast implants do not appear to have a higher mortality rate from breast cancer compared to women without breast implants. Breast implants do not obscure or interfere with patient self-examination or physician breast examination, which are at least as important as (if not more important than) mammography for breast cancer screening.

Michael Law, MD
Raleigh-Durham Plastic Surgeon
4.5 out of 5 stars 40 reviews

Mammograms And Implant Rupture?

+1

Thank you for the question.

Although theoretically possible it is very unlikely/unusual that a mammogram would rupture any type of implant. Every experienced plastic surgeon probably has anecdotal evidence to the contrary but it is hard to prove if the suppose it mammogram  related rupture  was really causative.  In other words, the implant may have ruptured prior to the mammogram study.

In your case, given that your implants will be 16 years old, I would suggest an MRI. As you know this is the most useful test to evaluate the integrity of the silicone gel shell.

I hope this helps.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 718 reviews

Mammograms and implant rupture

+1
I have seen patients where rough handling during mammography has caused implant rupture so this can happen. I always recommend that patients inform the radiologist in advance that their breasts have been augmented so the radiologist can instruct the mammography technician accordingly. There is a big variation in MRI prices depending upon the center but there are outpatient radiology clinics which will perform an MRI for about $400. If your current implants are not ruptured or show signs of deterioration/leakage on MRI, they do not need to be replaced prophylactically. This would be a strictly personal decision.

Robert L. Kraft, MD
New York Plastic Surgeon
5.0 out of 5 stars 11 reviews

Mammogram and implant rupture

+1

It is possible that a mammogram could potentially rupture your implants, but it is highly unlikely. Most are experienced dealing with implant patients.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 17 reviews

Mammograms and breast implants

+1

The risk of breast implant rupture increases with age of the implant. I would not worry about it, as you need to do your routine screening.  The implants come with warranty also, so that is a reassurance.

I would bet that the insurance comapny can find out that you have implants with no trouble at all, so I would not recommend lying on your forms.

Finally, I would not recommend exchanging the implants unless you have a problem with your current ones, as you will be subjecting yourself to risks, and you want to be sure that the advantages outweigh them.

Scott E. Kasden, MD
Dallas Plastic Surgeon
4.5 out of 5 stars 46 reviews

Safe mammograms after breast implants.

+1

Hi.

It's possible to rupture breast implants during mammography but it is very rare. What you need to do is find a mammographer who does hundreds of mammograms on women with implants, because there are special techniques needed. You certainly don't need to replace your implants.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
5.0 out of 5 stars 9 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.