What imaging should be done after bilateral leaking ruptures were detected following a serious auto accident?

My breasts were injured in a car accident a month ago. ER did an ultrasound which revealed that both saline implants were ruptured and leaking. Attention to those ruptures ASAP was advised as well as further imaging. Since a mammography is too painful and could potentially cause more serious damage to the implants. what other imaging do you recommend to determine the extent of injury to my breasts and/or if there are other anomalies to look into?

Doctor Answers 7

Saline Implant Rupture?

Hello,
I you sure you don't have silicone gel?  Saline rupture always manifests as leaking and deflation, no radiologic study necessary. If you have silicone gel implants, and they actually did see rupture on high definition ultrasound, using an MRI might confirm the findings. However, women in your situation who have had MRI's that were positive or silicone gel implant ruptured have been 100% incorrect when surgically operated on in my practice. My recommendations is to wait 3 months until trauma subsides and you are no longer feeling pain and visit your surgeon to discuss MRI.
Best.


Beverly Hills Plastic Surgeon
4.9 out of 5 stars 79 reviews

Breast implants

I am not entirely sure why you need more imaging? An MRI is more sensitive but why do you need it? If you have chest wall trauma then a CT may be better if you are concerned about additional soft tissue injury then MRI. You need to see a PS, be examined and taken through the pros and cons of removal only and removal and replacement. Not sure you need more imaging.

Gary L. Ross, MBChB, FRCS
Manchester Plastic Surgeon
5.0 out of 5 stars 142 reviews

Imaging for Breast Implant Rupture

The best imaging is MRI to detect a rupture.  Ultrasound is very unreliable.  If you have saline implants rupture should be fairly easy to diagnose by clinic evaluation.  If your breasts are smaller and the implants have flattened or have a hollow upper pole than your probably ruptured them.

Christopher Costanzo, MD
Thousand Oaks Plastic Surgeon
5.0 out of 5 stars 33 reviews

Imaging

I'm not sure an ultrasound is the diagnostic tool of choice to evaluate ruptured implants, and even if it is suggestive of rupture, a physical exam is all you really need. Are your implants smaller, maybe one side more than the other, do you see/feel any rippling in the implants?

Are you sure they are saline? An ultrasound would be slightly more helpful with silicone implants. 

In any case, your next step is to see a BCPS, have him/her evaluate you and determine the next steps. Should any further imaging be required or recommended, s/he can then arrange that for you. 

Best. 

Kirk Moore, MD
Salt Lake City Plastic Surgeon
4.2 out of 5 stars 39 reviews

What imaging should be done after bilateral leaking ruptures were detected following a serious auto accident?

Leaking saline implants do not require an MRI or other imaging  test.  It is important to remove ruptured saline implants as soon as you can.  This saline will not harm you.  However if deflated saline implants are left in for longer periods of time the breast implant capsule will tighten, become smaller and require more surgery to replace the implants.  Please see your board certified plastic surgeon as soon as possible.

Ruptured implants

Not sure you need additional imaging since you already have confirmation of bilateral ruptures. Best to see a board certified plastic surgeon who can examine and evaluate you for possible removal/replacement. Good luck!

Leaking saline implants - what tests are needed

Thank you for your question about your saline implants.
  • If your saline implants are leaking or have gone flat, the saline is absorbed and will do you no harm.
  • The ruptured implants need to be removed and replaced.
  • The sooner you have them replaced, the easier it is for the surgeon to do. 
  • You need to see a qualified plastic surgeon -  who will do a careful breast examination -
  • It would be unusual to need additional studies before implant replacement.
  • I am very sorry you were in such a severe accident and hope you are recovering well from any additional injuries.
Always see a Board Certified Plastic Surgeon.
Best wishes. Elizabeth Morgan MD PHD FACS

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.