Women often ask me if they have to undergo an MRI after breast augmentation with silicone implants.

The FDA recommends that women obtain an MRI 3 years after their breast augmentation with silicone implants, and then every 2 years after that, to look for a "silent leak."  This is a recommendation only, and not an absolute requirement, and therefore each women may decide for herself. 

The issue is that if a silicone implant leaks, it might not be detected by physical exam.  Because silicone is not reabsorbed by the body, it will most likely just stay within the capsule (scar tissue) around the implant, and this leak may be "silent" and go undetected.   With time, the silicone may move outside the capsule, and then it may feel like a lump under the breast tissue, and then it will be detected by physical exam, or by a self breast examination.  Alternatively if a saline implant leaks, your body will reabsorb the saline, and you will notice that your breast is much smaller. 

Because MRIs to search for a leaking silicone implant are expensive, and usually not covered by insurance, most women I see opt to not undergo an MRI.  And most plastic surgeons, and a lot of other physicians, feel that this is safe. I recommend to my patients that if they choose to not undergo the MRI, that they should undergo a breast examination each year.  If I, or another physician, find anything suspicious on physical examination, then we can always order an MRI. 

Also, it is important to remember that a leaking silicone implant poses no systemic health concerns, meaning that you won’t get “sick” or develop an illness due to the leaking silicone.  If the leaking silicone is left in the breast tissue for years, than you may develop a hard lump called a silicone granuloma.  At the time of implant removal, this granuloma may be removed as well.