What Does the Future Hold for Silicone Breast Implant Imaging?

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High Resolution Ultrasound May Replace the MRI

Silicone breast implants are one of the most extensively researched medical devices in the US. They have a high safety profile and are being used increasingly with good product performance. Breast implant shell failure is one of the concerns many women express when investigating choice of implant type. If the shell of a saline implant develops a break the fluid spills out and deflation occurs within days. If a silicone implant experiences a break in the shell, it generally requires an imaging study to confirm.

The implants currently marketed in the United States are referred to as “Fourth Generation Responsive Gel.”  These implants have a silicone center that is thicker than earlier implants. Because of the viscosity, if there is a break in the envelope, shell failure, the gel tends to stick to itself, rather than oozing out of the sac like syrup.


Detecting a leak involves some form of an imaging study.  Mammograms give a certain amount of information about the status of an implant, but are not sensitive enough to pick up every rupture. A negative study can give false reassurance that the implant is intact.


A MRI, magnetic resonance imaging, is considered the Gold Standard. The FDA has recommended a post operative MRI at year three and every two years thereafter. There is no scientific evidence that backs the timing of this recommendation, and most plastic surgeons believe the recommendation is overly cautious.  Both the cost and the inconvenience of MRI exams are barriers to women using this for follow up.

Additionally, MRI exams can over read, meaning give the appearance of a rupture where none exists. This can lead to unnecessary surgery.


Technology advances in some areas with mind boggling speed. Medical imaging is a field of rapid technological expansion. As predicted, there is an emerging technology that is not yet market ready that promises to vastly improve post operative imaging of silicone implants.


High resolution ultrasound is being studied for its ability to give accurate information about the shell of silicone breast implants. Preliminary research is published in the Aesthetic Surgery Journal, February 2012, p.157.  The authors report that as they refine this ultrasound technique, it may provide relative affordability, accessibility, and availability. It’s good news for the future of monitoring the shells of silicone breast implants.

Article by
Seattle Plastic Surgeon