Mammogram on 25 year old gel implants

My implants (made by Dow Corning) are over 25 (got them the beginning of 1986) years old and are silicone. I am scheduled for a mammogram in 2 weeks and am seriously considering cancelling. I am afraid the procedure might rupture my implants because they are so old. Is an ultrasound just as good?

Doctor Answers 13

Answer to 25 year old Breast implants

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Unfortunately, it is highly likely that one or both of your implants are already ruptured.  While this is not an health risk, ruptures can lead to capsular contracture and other local problems with the tissue.  I would recommend that you proceed with the scheduled mammogram.  This may yield some information on your implants, but more importantly, it is necessary to evaluate for breast cancer.  

Of course, you could consider having an MRI, but this is expensive and (in my opinion) unnecessary.  An ultrasound is not adequate to screen for breast cancer.  

Discuss these issues with your physician and plastic surgeon.  I generally recommend that 25 year old implants be exchanged.  In my experience, most  implants this old have already ruptured and are associated with capsular contractures.  Good luck.  

Charlotte Plastic Surgeon
4.7 out of 5 stars 29 reviews

Mammogram, 25 year old silicone gel breast implants and implant rupture

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Thank you for your question. I understand your fear of damaging your breast implants.

Since your breast implants are 25 years old, it is very likely that your implants are already ruptured.  The gel may sit silently inside the scar pocket that is surrounding your implant and not cause you any problem. If the gel ever gets outside the scar pocket, that is when you may notice a lump or a change in breast shape.

You  have some options. When you get your mammogram, let the mammographer know you have breast implants. Some extra views can be done, and the mammographer should be able to displace your breast tissue away from the implant.

Also, you could get an MRI which is sensitive for detecting both breast cancer and breast implant rupture. The problem with MRI is, it is expensive and may not be a covered benefit by your insurance company. A pre-approval would likely be required.

An Ultrasound is not good at detecting breast cancer.

Missing a breast cancer is not worth the risk. One in 8 women will get breast cancer during their lifetime. I recommend getting the mammogram for breast cancer screening.

Consider spending the money you would have spent on getting an MRI on replacing your old Dow Corning implants with new fourth generation implants that have a better shell and higher viscosity gel.

Always consult your doctor for final decisions. This information on the Internet is simply intended to help you ask better questions when you go see your doctor.

I hope this helps.

J. Jason Wendel, MD, FACS
Nashville Plastic Surgeon
5.0 out of 5 stars 221 reviews

Possible rupture of old silicone implants

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Ultrasound is not a good screening test for breast cancer. Mammograms and MRI's are much better. If your implant ruptured while getting a mammogram, it was on the verge of rupturing anyway. This whole discussion is probably a moot point. The implants you have are a 'low bleed' type. Meaning that silicone has already leaked through the shell so there is already free silicone in your implant pocket. There is a pretty good chance that one or both of your implants are already ruptured. You may want to see a surgeon about replacement but do not put off your screening test for breast cancer.

James McMahan, MD
Columbus Plastic Surgeon
4.8 out of 5 stars 40 reviews

Best Test for Breasts with 25 year old Breast Implants

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The best test without a close second to look at the breast is the MRI. The MRI will show the earliest forms of cancer MUCH earlier before a mammogram and years before an ultrasound. It will show a breast implant leak MUCH better than a mammogram. In addition, it involves NO ionizing radiation (like a mammogram or CT) and will not compress the breasts the way a mammogram will.

The reason we do not use more MRI is the cost. But when you consider the cost to you of a breast cancer or a ruptured implant most women would opt to pay for it out of pocket. It is a much better investment in your health than many other items you may spend similar amounts of money on.

Peter A. Aldea, MD
Memphis Plastic Surgeon

Mammogram on 25 year old gel implants

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MRI better choice in general. But you should discuss with a boarded PSs in your area in person. Best of luck. 

Mammograms with older implants

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First of all it is important to understand that your implants are likely ruptured already; may have been for years.  When you first got your implants your body built a capsule of scar tissue around them.  When an implant ruptures all or almost all of your silicone will be contained within it because your body does not break down silicone gel.  This is why you wouldn't have noticed it and why we call it "silent rupture".  You are not in any danger.  A mammogram can potentially rupture an older softer implant resulting in the same thing: free silicone within the capsule.  An ultrasound is not as good an option for cancer detection.  An MRI scan will detect both cancer and a ruptured implant, but it costs significantly more so your insurance may deny it.   If this is the case I would get the mammogram for the cancer detection and put your money into having your implants replaced.  It's time.  Missing a cancer is worse than having a ruptured implant.

Lori H. Saltz, MD
San Diego Plastic Surgeon
4.3 out of 5 stars 29 reviews

Mammogram, MRI and Breast Implants

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The breast can be screened for cancer using either a mammogram or an MRI.  The MRI is more sensitive however due to its expense, it is rarely the first method of choice for breast cancer screening.  However, the current FDA recommendations are for a screening MRI for all silicone implants after three years to detect a rupture.  While this is sometimes overkill for implants that are new and asymptomatic I would strongly recommend an MRI to anyone with implants that have been in longer than 20 years.   There is a high probability that implants that old have some leaking or rupture that has occured and should be exchanged.   Discuss it with you plastics surgeon and consider getting a MRI instead, both to screen for breast cancer and for implant rupture.  You may be able to kill two birds with one stone.

Adam Hamawy, MD
Princeton Plastic Surgeon
4.8 out of 5 stars 57 reviews

Mammogram, mri, ultrasound and old silicone implants after breast aug

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Implants this old probably need replacing.  an MRI scan is the best choice at this time to look at the implants and breast tissue.  

You need to look at your breast tissue.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

Breast Implants and Mammograms

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Hello Shenandoahgirl,

Based on statistics, your implants are already ruptured!  Thats right, you are probably walking around right now with a ruptured implant(s).  Don't worry, this is not a health risk.  You should however entertain the idea of not only getting a mammogram to assess your breast tissue, but also a high definition ultrasound or MRI to assess the status of your breast implants.  To answer your question though, mammograms have never definitively been shown to cause rupture of implants.  On the other hand, women in their 50's who have not gotten a mammogram are at higher risk of missing a breast cancer at an early stage that can be cured.

Get your mammogram!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 100 reviews

25 yo gel implants and mammography

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The durability of gel implants has changed dramatically for the better over the last ten years. Your 25 yo implants may be fragile and subject to rupture with standard mammography. Request an MRI exam which is a good screening tool for detecting breast cancer and determining the integrity of the gel implants. An ultrasound exam is not a good option. Your insurance may not cover the cost of an MRI -but it is worth the effort to request the exam.

Joseph N. Togba, MD
Oakland Plastic Surgeon

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.