How to detect a rupture/leak in silicone implants?

Although it is true, going to a typical radiology center for mammos and ultrasounds is not the place for implant evaluation, the use of high resolution ultrasound (HRUS) is the mainstay of implant evaluation in 2023. These devices are almost exclusively found in plastic surgeons' offices, and they are used to survey the implant shells for defects. For surgeons facile with this, it can take about ten minutes with a greater than 98% accuracy. If your surgeon doesn't have one, he/she can order an MRI, but that will cost a lot of money as insurance does not typically cover implant surveillance. Although implant rupture rarely has symptoms, you are 11 years out and need to have either HRUS or an MRI.

Hi Dianari,
I would recommend that you reach out to the surgeon who did the implantation. They can order a Breast MRI, which may better detect a leak/rupture than an ultrasound or mammogram. Occasionally, even a breast MRI will not show a leak/rupture that is present.

A mammogram and ultrasound are about 90% accurate in detecting a leak. If the radiologist wants an MRI, it then can be ordered. It will be about 95% accurate. Only God is 100% accurate. With surgery, of course, the implant can be examined to see if it is ruptured.

I suggest you follow up with your plastic surgeon if you have concerns about your implants.
Unless you’re having symptoms or there is a problem, you probably don’t need to do anything.
Breast discomfort is common, and most women will deal with some breast discomfort on and off through their life.
The most accurate test to assess implant condition is an MRI. It is substantially more accurate than ultrasound or mammography.
The chance of silicon implant rupture does increase with time. 10 years, the chance is still fairly low.
When silicone implant rupture happens, usually patients will not be aware of the change until months later.
If there is a reaction to the ruptured implants, it is usually a very gradual development of capsular contraction.
Capsular contraction typically causes the implant to feel firm and severe capsular contraction. The implant can feel like a tennis ball and can be painful.
Mild cap or contraction typically has no other than feeling slightly firm.
If you read the implant manufacturers recommendations, it is to screen for rupture using MRI on a regular basis. Very few patients actually do this.
The cost of an MRI for cosmetic purposes is going to be quite expensive.
If patients are having medical problems including problems from their implants, then an MRI can be covered by medical insurance. Authorization and medical coverage is something you need to review through your policy.
If you have concerns, then your first step should probably be to follow up with your plastic surgeon if that is possible and convenient.
Best,
Mats Hagstrom, MD