Conspiracy theories and urban legends are common in society. Big Foot, UFO's and in my part of the United States, the blood sucking "Chupacabra" are legends many of us have heard of. Plastic Surgery and Breast Implants are also filled with urban legends and conspiracy theories that can confuse and scare the public. Many of our patients have asked plastic surgeons about implants "popping" while traveling in an airplane, the need to change the implants every ten years and the idea that "black mold" is common with saline implants. All of these concerns are spooky urban legends. So, the answer to your question is that mold is not common with saline implants. As a matter of fact, if an implant or breast pocket were contaminated or infected with mold, the patient would be very sick. In other words, it is highly unlikely that someone would be infected with mold and not be very ill. Now, your question does bring up a good point. During implant surgery, surgeons use many strategies to decrease the risk of infection or contamination of the implants. Fortunately the risk of infection, requiring the removal of an implant, is less than 1%. However contamination with a mild form of bacteria, that does not cause fever or redness, can occur. These bacteria, which are not mold, form a layer on the implant that protects the bacteria from your immune system and antibiotics. Although affected patients do not show the normal signs of infection of fever or redness, they can form contractures, or stiffening of the implant, a year to several years after surgery. These breast contractures have to be treated with removal of the implant and scar tissue around the implant (capsulectomy) and replacement with a new implant. This occurs 1-4% of the time and most breast implant companies have a warranty that provides our patients with a new implant, at no cost, should this occur. The Aesthetic Surgery and Research foundation (ASERF) has endorsed the "14 Point Plan" to decrease the risk of implant contamination and complications. The whole concept is to utilize 14 strategies to to decrease complications with implants during surgery. Some of the concepts include, the proper use of antibiotics, double gloving during surgery, minimizing the contact of the implant with the patient's skin, etc... So, the point is that plastic surgeons are constantly trying to find ways to make breast implant surgery safer for our patients. Thanks for your question and I hope this was helpful.