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.

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,

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.

Marcus L. Peterson, MD · Answer

The FDA did extensive studies on silicone implants as well as many other organizations.  Scientifically they have determined that there is no safety or health risk with silicone implants, even if the implant shell is leaking.  If we knew an implant was leaking the proper recommendation would be to have it replaced.  With todays technology, an MRI is the only reliable way to diagnosis an implant break.  You also have to keep in mind that an MRI is not 100% accurate.  Even though there is no science to the recommendation by the FDA it is part of the implant approval program.  Since it is a recommendation to you as a consumer it is up to you to decide what is the best course of action for you.Many times if you suspect there is something wrong with the implant it also might be a good indication to return to surgery to do an inspection of the implant and correct anything else that might need to be adjusted.  Essentially, you should have the FDA information and then you can make an informed decision.Best WishesDr. Peterson

Victor Ferrari, MD, FACS · Answer

The FDA recommended MRI scans every 2 years just to see if the implants ruptured.  This is not a requirement nor are you in grave danger if the implants have ruptured.  The new style implants should easily last more than 10 years.  I have been doing this for 20 years and put in thousands of implants.  I can count on one hand the number of patients that actually did these MRI scans.

Robert T. Buchanan, MD (retired) · Answer

When the FDA approved silicone breast implants again in 2006, they did suggest that the implants be followed every 3 years with an MRI. That recommendation was based on data on the older implants where the MRI could relatively easily detect a tear and leakage of the silicone out of the shell. Since the new generation of silicone breast implants are highly cohesive gel and do not leak out of the shell like the older implants, the FDA has rescinded that requirement. Even if it had not done so, I, personally, never recommended such follow-up since I would do nothing, even if I knew the implant were ruptured, unless the patient were having symptoms. I, in fact, followed many women with known ruptured implants over many years and rarely saw a problem. I, therefore, used MRI's only if the patient were having a problem as you suggested. (Just for your information, an MRI does not produce radiation since it produces it's images through a different technology.)

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

Answers (8)

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