It is important that patients understand and know that breast implants that are currently on the market are surprisingly more durable than what most people think. Breast implants that were produced prior to 1992 had very thin shells and do not have the capability to withstand as much pressure as present day implants.
Average sized breast implants used in today’s procedures can withstand up to 200 to 300 pounds of pressure before they experience any type of rupture. This amount of pressure is much more than what is generated during an average mammogram. However, this does not mean that it is impossible for a breast implant to rupture during a mammogram procedure. If, for some reason, deflation occurs during a mammogram, it is very likely that the implants had already lost some of their integrity and were probably on the verge of rupturing.
The warranties against implant rupture provided by both breast implant manufacturing companies, Allergan and Mentor, are not voided if an implant breaks as a result of a mammogram, since they provide lifetime implant replacement for deflation.
Saline Implant Ruptures
Identifying after effects and correctly diagnosing a breast implant rupture depends on the type of implant that was inserted. If a patient had saline implants placed at the time of her breast augmentation procedure, detecting a rupture is not a difficult task. When a saline implant ruptures, all of the saline fluid contained within leaks out, resulting in the implant shell collapsing and making the breast considerably smaller. Since an obvious change in the size of the breast can be seen, unless the implants are very small, no special tests are necessary to detect a saline implant deflation.
On the other hand, when a silicone implant ruptures, the result is very different. When a silicone implant ruptures, the gel contained within gradually works its way out of the ruptured shell. However, the overwhelming majority of it stays inside the scar capsule around the implant. As a result, the size of the breast does not change much, making it more difficult to detect an implant rupture by examination alone. In order to correctly detect the rupture, the FDA recommends patients with silicone breast implants undergo an MRI scan three years after implantation and every two years after that.
Magnetic Resonance Imaging
As is true with virtually all medical testing procedures, MRI’s are not perfect tests. False positives and false negatives occur resulting in misdiagnoses and, potentially unnecessary procedures. They are, however, significantly better than mammograms, ultrasound or CT scans for detecting ruptures.
For his eighth grade science project, my youngest son took a bunch of saline breast implants and measured how much pressure they could withstand before rupturing by placing them on a scale and piling bricks on them until they exploded. Implants in the 300-350cc range could take, on average, about 175-200 pounds of pressure while smaller implants around 200cc’s in size could handle over 300 pounds of weight before deflating. In other words, breast implants can take a large amount of pressure before deflating; much more pressure than is put on a breast during a mammogram.