Your Questions

Q:  I had silicone breast augmentation last year in 2010. I just read that I am supposed to get MRI scans every couple years to make sure they are not ruptured. My doctor never mentioned that I needed to do this. Should I get them and who is going to pay for them?

A: With the release of silicone gel breast implants back onto the market in late 2006, the FDA recommended regular follow-up magnetic resonance imaging (MRI) scans for women so implanted to detect rupture. Silicone implant rupture is ‘silent’, meaning it can not be detected by sight or feel. This is quite different from saline breast implants which will spontaneously deflate or go flat should there be a problem with them.

The MRI evaluations was one of the conditions imposed upon the manufacturers and it is so stated on their websites, marketing materials, and in the package insert. Plastic surgeons are instructed to advise their patients about the MRI recommendations. With this MRI recommendation, however,  there are no guidelines for tracking whom has this done, their compliance and most importantly from the patient’s standpoint whom is going to pay for these tests. It is clear from the FDA viewpoint that this cost is to be borne by the patient and/or their health insurance carrier.

But a recent article in the March 2011 issue of the journal Plastic and Reconstructive Surgery raises questions about the accuracy of such MRI scanning, especially in women without any breast symptoms such as pain or breast hardening. Beyond the issue of accuracy, the authors of this paper also point out that such screening tests are generally performed to detect diseases with serious health risks…and silicone breast implants are not known to have such significant risks

There is also a concern that there may be an overestimation of the ability of MRI to detect ruptured breast implants, particularly when scans are performed for screening purposes in symptom-free women.

This being said, your awareness of the recommendation of screening MRIs after silicone breast augmentation is important. What you do with this information is a matter of voluntary compliance and should be discussed with your plastic surgeon.

Dr. Barry Eppley

Indianapolis Indiana