Can an ultrasound show if an implant was ruptured?

Question

I’ve had an under the pec muscle silicone breast implants for 10 years. One looks off and shifted to the side. Sometimes, I think it might be ruptured. If possible, I prefer not to do an MRI right now. Can the breast ultrasound catch if an implant was ruptured or damaged? Thank you!

Azita Madjidi, MD, MS, FACS · Answer

Ultrasound is not a gold standard for detecting ruptures of silicone implants. However, it could sometimes detect a rupture if is really obvious on images but it could misread and have false ruptures. MRI is the gold standard. If you want to replace your implants, I wouldn't get any imaging since your surgeon can see if there is a rupture once the implants are out.

Donovan Rosas, MD · Answer

MRI is the gold standard for detection of rupture.

Manufacturers recommendation is for initial surveillance imaging at 5 years post op and then every 2-3 years after.

With regards to your specific question, most silicone ruptures are silent and can only be detected via imaging. A change in appearance does not necessarily indicate a rupture (it often doesn't). 5th generation devices are much more durable than the older versions. At 10 years the likelihood of failure remains relatively low.

US is an option but is not the first line choice. A negative US does not necessarily guarantee a negative result.

As always, discuss your concerns with a board certified plastic surgeon (ABPS).

Brian K. Reedy, MD · Answer

Thanks for your question!
Ultrasound can evaluate the integrity of the implant, a rupture, or any damage. Reach out to your surgeon to get one scheduled. Best wishes!

Ted Eisenberg, DO, FACOS, FAACS · Answer

An MRI would be necessary for a definitive answer. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Gerald Minniti, MD, FACS · Answer

Over the last decade forward thinking plastic surgeons have helped to bring office based HRUS to plastic surgeons. It is an invaluable device that far exceeds its intended use for implant surveillance. Surgeons like myself use it daily, both in and out of the operating room. A recent study published in the scientific journal Plastic and Reconstructive Surgery have shown sensitivity rates of 98% and specificity rates of 97% in experienced plastic surgeon users. This is non-inferior to MRI. All my patients get scanned and it takes about 15 minutes.

Ronald J. Edelson, MD · Answer

An MRI is considered the definitive diagnostic for a leaking silicone implant. Personally I would not operate on someone just based on an ultrasound

Matthew Zeiderman, MD · Answer

This is an excellent question. Ultrasound is a great first step to assess if an implant is ruptured and much cheaper and more accessible than an MRI. however, it is also more subject to the skill of the reader of the images and how well the images are performed.Start with the ultrasound. IT will most likely give you the correct answer.

Camille Cash, MD · Answer

Yes often times a breast ultrasound can determine if a breast implant has ruptured.  If there is a question further testing may be necessary.  Visit with your surgeon for an evaluation. The symptoms you describe do not necessarily indicate a rupture.

Connie Hiers, MD, FACS · Answer

Yes, an ultrasound is a great place to start to see if there is a rupture or just a fold in the implant. If needed, the mammogram can then be added.

Can an ultrasound show if an implant was ruptured?

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