Can a 40 year silicon breast implant have micro leaks? They gave me an MRI and can't find leakage.

Thank you for your question! I personally suggest if you have any doubts with your implants that they should be removed or replaced! Best of luck!Dr Dhaval PatelDouble Board CertifiedPlastic SurgeonChicagoHoffman EstatesOak Brook

Issue 1 - Microleaks: Gel bleed is common in breast implants manufactured before 1994. Implants of this age or older can allow a small amount of the filling silicone gel to migrate through the shell, like helium can get through a balloon without an obvious hole. In 1994 implant shells improved dramatically, with very low rates of gel bleed, tougher shells and improved silicone quality. Issue 2 - MRI detection of leaks. The best data we have shows that the MRI is 90% accurate in detecting leaks when one is suspected by a plastic surgeon. It is the most accurate test we have short of operating and checking the implant by hand.Issue 3 - Unknown Illness. While there are been case reports of women feeling better after removing their breast implants, large studies fail to demonstrate an increased incidence of any diseases in women with breast implants. Breast implants do not seem to increase a woman's risk of connective tissue disorders in particular. Removing your breast implants does not have a statistically significant change of curing your illness.While removing your breast implants may not help you feel better, keeping them is an elective decision. The risks and benefits need to be evaluated with a Board Certified Plastic Surgeon. Removing intact Breast Implants is relatively simple. According to your MRI, you have a 90% of them being intact; however, there is a 10% chance that your breast implants are ruptured, and this can make surgery more complicated. If you did not have the MRI, pre 1985 breast implants probably have a 50/50 chance of being ruptured, and all of them have gel bleed, and this is reason enough to seriously consider having the implants exchanged or removed.

Implants that are that old of probably disintegrated. The silicone will be contained by the capsule. I would recommend that you have them removed. I don't think you will have any effect on the other symptoms that you're talking about.

In the cases I have seen of 40 year old implants, nearly every one was not only ruptured but disintegrated.  Sometimes if the entire capsule has degraded the MRI can miss a rupture.It is time to replace the implants or have them removed and do a lift.It's uncertain whether that will help your symptoms; hopefully it will, but independent of that issue, it is time to deal with the implants.

An MRI although the most sensitive diagnostic study for breast implant integrity is used most often when one wants to keep the implants.  With a 40 year old implant, based on age alone, your incidence of leak or rupture within the capsule is probably 75% or higher.  So knowing this, a negative or equivocal MRI does not rule out a leak.  As an MD, I cannot comment our your medical condition as it relates to surgery, but might want to have the implants removed when your are able.

MRI's  can read both false positive and false negative. Yours may or may not be ruptured. If they are, it is unlikely they are responsible for your symptoms. Large studies over many years have found no credible link to to systemic diseases and symptoms like you describe. If you have any concern after that information, you could certainly opt to either replace them to be certain your implants will be intact, or remove them. Your symptoms may or may not improve.

My advice would be to remove the implants regardless of what an MRI shows.  The gel of that era has most assurdedly migrated through the shell; however, the shell has very likely ruptured.  I would say remove the implants and silicone and let yourself heal.  

Before Cohesive gel implants were released, all of the prior models had an expiration period of ten yearsm when is time to replace them because of leaking the low density gel in a thin membrane inside the capsule. In your case just the clinical story is enough to know what to do, a replacement. In the recent cohesive models we need to do an MRI in 10 years after placement to see if they are ok.