Is getting a MRI every 2 years to check on silicone implants really necessary?

Question

I am considering getting breast implants and I am leaning towards getting silicone implants instead of saline, but ultimately safety is the most important factor for me. I know the FDA recommends getting a MRI every 2 yrs, is that really necessary? I would rather not be exposed to the radiation from a MRI every 2 yrs and they are expensive. Can I just get an MRI if I detect anything might be wrong with my implants?

Mathew C. Mosher, MD · Answer

You have received good information from other Plastic Surgeons already. It was a recommendation from the FDA for women to have screening MRI exams of the breast to detect "silent ruptures" of silicone gel implants. In Canada, we have been using highly cohesive silicone gel implants since 2002 without Health Canada recommendations for routine screening MRI's. The real danger of too many MRI's is not radiation (this is an issue with Xrays and CT scans only) but the unnecessary expense to patients and even the possible harm caused when falsely positive scans are reported. Detecting rupture of newer silicone gel devices is much more difficult than saline devices. However, missing a ruptured silicone device for a period of time is not associated with any known health consequences. If you notice a change to your breasts, you should bring this to the attention of your primary care physician or Plastic Surgeon and appropriate investigations can then be recommended. There is no longer any rationale to being fearful of missing a ruptured gel filled device.

Scott Tucker, MD · Answer

I don't routinely get MRI studies on my patients. The initial info from the FDA recommends this, but this has since changed. If someone has sign of rupture it is a good test. Often times if the implant are old and there us a question, your better off spending the money to replace your implants instead of getting a study.

Ryan Neinstein, MD, FRCSC · Answer

Great question, a discussion we have all the time. First of all there is no radiation with MRI the issues is time and cost (about $2000). It is recommended to have, however, anecdotally I dont think most people do as the cost of surveillance would be more than the surgery. If someone is really worried I suggest saline, a great implant still and less issues to think about

Curtis Wong, MD · Answer

Absolutely NOT!  The government recommends that it be done but it is not a mandate and you can choose whether you wish to follow that outdated recommendation.  If you have soft, unchanged breasts and are without concerns, MRI's are never recommended in my practice.  To the best of our knowledge, silicone is not implicated in any systemic diseases or disorders at this time and that hasn't changed since the year 2000.

Asif Pirani, MD, FRCS(C) · Answer

There is no such requirement in Canada.  There is no radiation with an MRI.  Xrays and CT scans give off radiation but MRIs do not.  The issue with repeated MRIs is the cost you will incur.  I have my patients get an MRI only if they notice a change and are concerned about implant integrity.  Be sure to see a PS in your area about your local recommendations. Best,

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