25 May, 2023
MRI scans – should I do this every few years to check for any ruptures?
This is a complex and important question. There is no indication for regular MRIs in my opinion to check the state of the implants. An MRI should be carried out only if there is clinical suspicion that there is something wrong with the implant. For example a volume change, a change in shape or the presence of pain, may indicate rupture (implant failure) or capsule formation. I also believe if the patient is anxious , or feels she is experiencing odd symptoms or the implants has been in a very long time; then a scan should be done. A simple ultrasound is probably as good as an MRI in the right hands for detecting implant rupture. If an implant is damaged then they should be removed with the option to replace them with a different implant, perhaps consider fat filling.
What is a long time? This is not really known but after 10 years it maybe prudent to have an ultrasound. This is an arbitrary figure based upon the fact that nothing man-made lasts for ever and the cause of implant failure is multifactorial. Unfortunately, sometimes I am sure that an implant maybe damaged and ruptured but not detected clinically. This is because the natural capsule that forms around the implant keeps the implant in shape and in position. This logically begs the question of whether it is dangerous to have a ruptured implant in your body with internal extrusion of silicone. The opinion of the majority of medical practitioners and available research of statistical data (known as meta analysis), indicates that it is not dangerous. There is no evidence that silicone is harmful to the human body although of course, if the silicone used in implants is of low-industrial grade (such as in the PIP implants), then I believe that they can cause side effects and abnormal internal inflammatory responses. In my practice with Nagor, Allergan and Mentor implants I have not seen ruptured implants causing serious systemic problems. For some PIP cases, I have seen bad abnormal capsule formation and lymph node involvement and also historically in patients who have had implants that ruptured many years ago with old generation implants.The patient has to listened to and examined carefully should there be some change in.
The other reason for scans and investigations would be for diseases that may affect your breast in the future. This is a separate issue and must be treated on their own clinical merits. The implants would not affect the efficacy or the way diseases of the breast itself can be investigated. There is no evidence that you are more at risk or there is less chance of diagnosing breast disease because of silicone implants. There is certainly no evidence that they cause cancer.