Saturday, August 30, 2008

Breast Implant Ruptures

A saline implant rupture results in quick deflation and is easily removed. Recent FDA approved studies show rupture/deflation rates of 3-5% at 3 years and 7-10% at 5 years. Older studies depended on clinical exams to determine rupture rates.

Recent reports have determined these exams aren't adequate to evaluate rupture rates. One study reported ruptures in asymptomatic patients are correctly detected by experienced plastic surgeons 30% of the time. This is compared to a detection rate of 86% by MRIs.

The FDA currently recommends MRIs be used to screen for ruptures beginning three years after implantation and continuing every two years thereafter.

Other countries consider MRIs useful only in cases of suspected ruptures and to confirm ultrasound or mammographic studies suggesting a rupture.

Silicone implant ruptures rarely result in deflation. The silicone leaks into the space around the implant. This indicates the need for removal of the implant. The risk and treatment of extracapsular leakage is controversial. It's agreed the gel is difficult to remove, but theres disagreement about the health effects.

The majority of MRI data for silicone gel implants indicates after 11 years, most women had at least one ruptured implant with silicone leakage outside the capsule of 21% of the women. The available long term data deals with 3rd and 4th generation implants and shows a 15-30% risk of silent rupture. MRI evaluation of the 5th generation implants implies improved durability. A rupture rate of 1% or less at an average age of six years is reported.
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