Post implant reconstruction: How often should you get an MRI?

@rn40, I found this information:
- Magnetic Resonance Imaging Screening after Silicone Implant Breast Surgery: Patient Survey of Adherence to U.S. Food and Drug Administration Recommendations https://journals.lww.com/plasreconsurg/abstract/10.1097/prs.0000000000009317~magnetic-resonance-imaging-screening-after-silicone-implant
"Starting in 2006, the FDA recommended routine MRI scans for detection of implant rupture, starting three years after surgery and every two years thereafter. However, clinical experience suggested that many patients did not follow this recommendation."

Have you asked your surgeon about the pros and cons of getting MRIs more regularly?

Since I had surgery and implant reconstruction 17 years ago, my breast surgeon has retired and I have not seen a surgeon or plastic surgeon in several years. When I looked on line for information I found some time lines for checking implants but they did not seem to be hard and fast, only suggestions

This question has dogged me since I had my mastectomy in 2009 (left side with silicone implant, also a "cosmetic" small implant on the healthy right side). I have been amazed at the silence regarding what happens over time after surgery and recovery is over. I have sought information and it's pretty much a black box. I was 53 when I had the mastectomy, and I know that implants don't last forever, but my surgeon is/was non-informative about the future. I've had three MRIs since surgery 17 years ago, and did meet with my plastic surgeon about 4 years ago after the most recent MRI showed intracapsular rupture in the cosmetic right breast implant.

She said there was no medical reason to worry about the rupture. She provided options (remove implant, replace implant, keep it, monitor it) but had no preference. Some of the options discussed were to update the surgery now that the healthy breast had drooped and the reconstructed one has remained high and in place (this entailed "drooping" the left breast to match the natural one! ) All up to me. I certainly do not want elective surgery but I also want to know how long before the implants require replacement, and is it better to just replace now while I'm still healthy and relatively young (70), or just ignore the whole thing and live out my life with the original implants. I just had a mammogram yesterday on my right breast, and as it was squished and squeezed in the machine I kept envisioning my ruptured implant and what this might be doing to it.

It's shocking to me how little information we patients get for future care and maintenance after our treatment ends. It's a bit discomforting. This discussion has led me to scheduling another MRI just for the information since it's been 4 years. But will the information do any good? Stay tuned...

@jdwelch2025 I was shocked, when reading your reply, how very similar our stories are. I also had my mastectomy in 2009, with implant to the right (mastectomy) side, and an implant also placed to the left. Like you, I do have some drooping of the left side, and have also had a biopsy to that side, which prompted a MRI 5 years ago, as I felt that it might have been punctured. Mammograms, are particularly unnerving when an implant is present. I am 79, in very good health and very active. I did have an incident with an adjustment by a chiropractor, which caused me to have symptoms in the right breast. I am scheduled to have an MRI at the end of August, although the symptoms (discomfort, itching, feeling of displacement), have subsided. I hate MRIs, and I am not sure what will be recommended if there is a rupture or leakage, so I am in a quandary. I've already postponed the MRI once, but think I should go through with it, for peace of mind. Like you, I have had no guidance, which is frustrating. Thank you for sharing, asI have not spoken to anyone whose situation is so similar

@rn40 It's nice to meet someone with similar history and questions. I too dislike MRIs, they are uncomfortable, disorienting, and the noise level is quite disturbing. But at least there is no radiation. I hope your MRI goes well, and know we are in this together!

Thank you, likewise.

I just had double breast reconstruction completed a month ago, and my surgeon instructed me that I should be checked for implant replacement 10-15 years from now. Those implants aren't meant to last indefinitely, especially older ones. I would definitely do the MRIs as described above (my friend had the same procedure, and her surgeon actually prescribed regular ultrasounds), and then meet about when surgeon recommends replacement of the old implants.

Thanks. Good luck to you

I just wanted to pass on a little information about implants from my own personal experience. I had double mastectomy 6/26/26 with direct to implant reconstruction with ADM. I wanted to pass on to anyone that it might be helpful to for future decisions- I specifically chose to have normal saline implants instead of silicone. They do not require as much monitoring, although you definitely want to follow your medical oncologist recommendation for follow-up screenings. If you have a rupture you immediately know with the normal saline. I want to add that ruptures are rare from what I know - silent ruptures with the silicone. I know that aesthetically they are not considered as good as the silicone might be, but for me less to have any concerns about. Things are going well for me so far and it looks like I am cancer free!! Wishing all the best. We have to support and help one another - it's a sisterhood.

I'd like to echo what janiern2 said about choosing saline rather than silicone. I agonized about choosing one of these and finally decided to go with saline. That was based partially on my age which was 75 at the time of surgery. I think silicone implant safety has improved from a few years ago to the point that now there are some plastic surgeons in my area who don't even offer saline. But I just didn't want to add one more possible issue to worry about, even if the worry is now minimal.

I'm pretty sure that should you choose a silicone implant, further MRI surveillance would be covered by your insurance but be sure to check that out.