Will a Breast MRI Always Find Silicone Rupture or Extracapsular Towards Armpit?

I have had my silicone implants for 9 years. They are behind the muscle. There have been some subtle changes in the sizes and shapes of both breasts, but I put this down to childbearing. In the last year, I have had some intermittent pain, redness and swelling to the right breast, especially in the armpit. I was referred for an ultrasound and it apparently showed silicone high in the armpit. The MRI with coils came out clear, but would this type of MRI definitely show that area?

Doctor Answers 19

Addressing a positive ultrasound but negative MRI in diagnosing a possible ruptured silicone breast implant

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As noted by the other responders, your results are conflicting between the ultrasound and the MRI. Even though the MRI is the most accurate diagnostic technique short of surgery, it is not fool proof and may be associated with around 10% false negatives (that is, it will not identify implant disruption 10% of the time on average).

The changes of your breast are most likely totally unrelated to the state of the implant. However, given your symptoms, it would not be unwise to consider a surgical procedure as they can be consistent with loss of implant integrity. If you are already considering some improvements in your breast such as a lift or size change, this surely would be the indication for you to proceed sooner than later.

Scottsdale Plastic Surgeon
4.7 out of 5 stars 33 reviews

MRI detection of silicone gel leakage

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MRI is good for detecting leakage of silicone gel implants, but by no means foolproof.

Most experienced plastic surgeons have seen many instances of false readings of MRI studies.

An experienced plastic surgeon can help you sort out all the tests and make a recommendation based on your physical exam (i.e. tender lymph nodes), the ultrasound (?silicone) and the MRI.

Usually lymph nodes that are palpable, abnormal warrant a workup and probable removal.

Obviously if implants are ruptured and there is a question of extruding silicone, they should be exchanged or removed as well.

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 194 reviews

Will a Breast MRI Always Find Silicone Rupture or Extracapsular Towards Armpit?

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If the scan showed free silicone you need exploration and possible explantation of the ruptured implant. Do not follow the results of the MRI. Just from your history I think of a rupture. From MIAMI Dr. Darryl j. Blinski

Nothing is 100%

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MRI is the highest in sensitivity of the available tests for the problem. Then again with the symptoms you are having I probably would have just recommended capsulectomy and implant exchange. This surgery has a good chance of improving your problems rupture or not.


Best Regards,


John Di Saia MD

John P. Di Saia, MD
Orange Plastic Surgeon

You may need implant exchange

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You have Multiple symptom that are consistent with ruptured implant. If you get MRI and it is negative you will need implant exchange because of the silicone in Scilla and also your symptoms. The other possibilty is silicone gel is leaking from the implant without gross rupture.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
4.7 out of 5 stars 152 reviews

Breast MRI

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Breast MRI is 90% accurate. When looking at large groups of women, MRI is a better test than breast ultrasound if you are trying to determine if a silicone gel implant is leaking. Physical examination is only about 30% accurate.  Accuracy is important when evaluating groups of people.

On an individual basis, the accuracy of a test can be reassuring, however for the individual one in ten test results are wrong. The only "test" better than an MRI in this situation is surgery. This is 100% accurate, and if there is a leak, it is also the best treatment. Unfortunately, there is much more involved with surgery than with an MRI. 

There are many causes for pain, redness and swelling in the armpit. Tests are helpful, but we don't treat tests. What to do next needs to be discussed between you, you surgeon and those who support you.

Joseph Mele, MD
Walnut Creek Plastic Surgeon
4.5 out of 5 stars 17 reviews

MRI for Ruptured Silicone Implant

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I would have to defer to a Radiologist for an absolute answer to your question.  MRIs are not 100% accurate in demonstrating a ruptured silicone implant.  However, I would be surprised if an MRI would not demonstrate an extracapsular extravasation of silicone into your axilla.

John Whitt, MD (retired)
Louisville Plastic Surgeon

MRI is not 100% accurate in detecting implant rupture

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I have had patients with ruptured silicone breast implants that have had negative MRI studies.  The MRI is the most accurate diagnostic test , but it has to be used in conjunction with clinical and historical evaluation to be helpful in the decision making process.

Dev Wali, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 58 reviews

MRI and breasts

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The MRI is the most reliable study to determine whether or not an implants is ruptured. It is the gold standard.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Will a Breast MRI Always Find Silicone Rupture or Extracapsular Towards Armpit?

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MRI are currently the BEST non-invasive method to detect implant rupture but they are far from perfect and data show that they are only about 89% accurate. This means that in more than 1 0ut of 10 patients the diagnosis will be wrong.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 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.