What is the best diagnostic scan to find out if silicone implants have ruptured and if the silicone has migrated? (photos)

Question

How do you find out if silicone has migrated to your liver or lungs or thyroid? Is there even a way to remove it, aside from just detoxing? I think I have serious silicone toxicity. A bioenergetic testing shows silicone dioxide has been deep within my tissues for a long time. I have had symptoms for several years, but never realized it could be do to silicone in my body.

M. Zakir Sabry, MD · Answer

Best test to assess the status of implant is MRI. Local infiltration of tissue may also be evident with MRI. However, systemic involvement may only be substantiated with bio-chemical testing, thorough physical exam coupled with imaging which may include X-ray, CT Scan, MRI etc.

Gary Lawton, MD, FACS · Answer

Magnetic resonance imaging (MRI) is the best diagnostic test to answer the questions that you are asking.

David Tauber, MD · Answer

Breast
implant rupture occurs when the outer shell of an implant develops a hole or
tear. It occurs in about 10% of breast implants.

The
rupture of saline implants often manifests in the deflation of the affected
breast as the saline leaks out and is absorbed by the body. The rupture of silicone
implants is often silent (asymptomatic), however, some patients will complain
of a change in shape, lumpiness, or new onset pain on the side of
the rupture. Silicone that leaks out of the shell is typically contained within
the breast capsule. Silicone can cause local reactions (granulomas), however,
there is no evidence that it can migrate distally or cause any systemic
symptoms.

Bioenergenic
testing is performed by transmitting a current between an electrode held in the
hand and a separate electrode pressed against the skin at another point and
measuring the resistance between the two points. This resistance measured
is influenced by distance between the points, the moisture (sweat) on the skin
surface, and how hard the probe is pressed into the skin. It is subject to
significant operator influence and inter-measurement variation. Although
bioenergetics testing has been promoted in one form or another since the
1950’s, there have been no scientific studies that demonstrate that the
resistance values can be used to diagnose any medical condition.

The
best non-invasive test for implant rupture is an MRI. It has an accuracy of 92%, a sensitivity of
89%, and a specificity of 97% at detecting implant rupture. In real world
terms, if a rupture is seen on MRI the implant is likely ruptured (94%). There
are some ruptures, however, that are missed by MRI (5%).

Consultation with a plastic surgeon would be the next best
step.

Vincent N. Zubowicz, MD · Answer

First of all I don't know you get this nonsense about silicone dioxide deep within your tissues. You must be dealing with some quack. The only test to determine the integrity of the implants 100% is surgery. MRI scans are the next most accurate with at least 10% being false positive or false-negative.

Christopher Khorsandi, MD · Answer

An MRI with a Breast Coil would be the best noninvasive way to determine if there is a rupture, but surgery is the single most accurate way to diagnose a rupture.  It is unlikely for silicone from a breast implant to migrate outside the local area of implantation.  Bioenergetic Testing is not a recognized field of medicine with little scientific evidence to support its methods.  I would consult with a board certified ASPS/ASAPS plastic surgeon in your area to examine you and discuss your options.

Aras Tijunelis, MD · Answer

An MRI is the best tool for detecting ruptured silicone implants and even some silicone granulomas and lymph nodes.  The MRI doesn't compress your breast like a mammogram would.

Connie Hiers, MD, FACS · Answer

Silicone implants are not the only source for silicone in our bodies. If you have the old gel implants, they do have the potential for leaking and might need to be removed. I would start with a mammagram, with possible ultrasound, to see where the gel is located. If needed, then get a MRI. It would be very unlikely for the silicone gel from implants to travel to your lungs without major trauma. However, we do see silicone gel, from time to time, in lymph nodes, especially in women with ruptured gel implants. Detoxification programs can be very helpful in general for most adults, however, silicone gel from implants is not usually removed without surgery.

Scott E. Kasden, MD, FACS · Answer

Hi Healthynewme.The gold standard for silicone implant rupture is an MRI of the chest.  The MRI can also detect silicone in other places.Objective well designed scientific studies do not find that silicone is associated with any systemic illnesses or toxicity.  Detoxing cannot be expected to do anything to eliminate any silicone from internal organs or tissues.  Past studies have not really demonstrated any benefit to removing silicone remote from the breast implant site.That said, if you feel you are having toxicity issues, I would recommend that you seek medical help, and your plastic surgeon would be a good start.Se

Jourdan Gottlieb, MD · Answer

The most reliable test is an MRI with a breast coil. Pretty much any breast center that does mammograms and has an MRI will have the proper coil. It is not a 100% test--almost nothing is, in that some leaks are missed, and some studies show a leak that turns out not to be one. The chances of your symptoms being related to your implants is slim.Best wishes.

Marvin Spann, MD · Answer

An MRI of the breasts is the best diagnostic study to diagnose rupture. It is highly unlikely that silicone has migrated to your liver, lungs, or thyroid. There is no test (including bioenergetic testing) that can can tell you whether the silicone from a leaking implant has migrated to other areas of the body, nor will detoxing have any affect. Silicone is inert, and there is no evidence that it causes silicone toxicity. If you suspect that your implant may be ruptured, most insurance companies will still require a mammogram before ordering an MRI. The only way to be sure that they have not ruptured is to remove them and inspect them visually. Talk to your plastic surgeon to discuss your options. You may want to have them removed in combination with a breast lift (mastopexy) to ease your worries. Good luck.

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