Are my silicone gel implants still intact is a question I get regularly at my Worthington, Ohio, plastic surgery office. Since I have been in practice over 25 years and have done literally thousands of silicone gel breast implant operations, my patients come to me for advice and guidance on this complex question.
MRI Breast Implant Imaging
The answer used to be harder to get at, since the best test to study the implant is the MRI. But that test is an inconvenient one, and often insurance plans will not cover it. This leaves the patient with the bill, which could be in the thousands. To make matters worse, there can be false negatives—in other words, the report will state the implant is not broken, but it really is.
Mammogram to Check for Breast Implant Rupture
As for mammograms, this test can be useful to determine if the implant is intact but also has false findings since no test is 100% accurate. The patient is often left in a confusing situation in which she does not have any symptoms or reasons to think the implant is broken, but after 10 years, the likelihood does increase, and many are just curious. They want to know if it is intact, then they are good to go for a little longer. Or if it is ruptured, then they want to proceed with a revision breast augmentation or implant removal. Again, many do not have any outward sign of any issue. So what is a patient to do?
Breast Implant Rupture Discovery With Ultrasound
This tricky question has just gotten easier to answer with the arrival of HRUS—high-resolution ultrasound. While ultrasound has been around for decades, the advent of our new brave digital handheld world has allowed this technology to be adapted for the office setting. It no longer has to be done in an ultrasound lab! It can be done with a patient in my plastic surgery office for a routine check-up.
Designed for the Plastic Surgery Office
And the technology is so sophisticated that it is designed with the plastic surgeon in mind—not a radiologist. In other words, it is easy for a plastic surgeon to use and add to the office visit to provide a glimpse of what is happening inside the patient.
Patient Peace of Mind
At Aesthetica, we all try to stay at the very top of our game by providing the utmost in patient care, from the ladies of the A-team at the check-in area to those who do the check-out. And as a plastic surgeon, my job is also to incorporate new technology and modalities that improve patient care. The addition of high-resolution for breast implant surveillance is a game changer. I have so many patients who just need some peace of mind. And now Aesthetica is able to offer this peace of mind. (You can learn more about how well HRUs provide peace of mind in this video explaining a recent study published in the Plastic and Reconstructive Surgery Journal.)
Helps With Patient Decision-Making
Of course, like mammograms and MRIs, there can be false negative results as well as false positives, but adding another aspect into the equation can help a patient decide how she would like to proceed.
What Happens During an HRU Breast Implant Visit
Now let me tell you about the actual test or procedure.
- First, you do not need to go to another site—I have it in my office, so it is convenient. When you put on the paper gown and I am ready to do the ultrasound, it only takes a few minutes to do each breast.
- Second, it is fast. And the results are in real time—no waiting around for a report. We will know, together, what is seen. And then we can immediately begin to chart the next best steps.
If a rupture is suspected, we can discuss revision. Since it is possible that the ultrasound result is a false positive for rupture, then we want to make sure, the timing is right, and the patient would probably have decided to go ahead with a revision, regardless of the ultrasound result. (Learn more about the breast revision procedure in my related blog post.)
If the result is negative for rupture, we will discuss the false negative result and what that means for my patient. Either way, it is always good to have more information. And if there are any major questions about the implant, there is always the option to proceed with additional imaging, such as a diagnostic mammogram or MRI.
Radiology Ultrasound vs. Plastic Surgery Ultrasound
It is important to discuss the difference between what a radiologist is doing with a breast ultrasound and what a plastic surgeon is doing. As a plastic surgeon, I am not trained to check the breast for signs of breast cancer. That is what a radiologist does. So this is a major distinction, and of course, as a plastic surgeon, my goal is to look at the implant, not the breast tissue. I think that this new technology will make life easier for my radiologist friends; they can focus on the breast tissue and mention the implant they see on an annual breast ultrasound but not have to worry about saying much more than the implant is present behind the muscle or in front of the muscle.
I am so excited to have this technology available, and I know that my patients will appreciate this level of expertise. It is what we strive for every day at Aesthetica. We want to deliver the very best patient care in a setting that is personalized to each patient.
Aesthetica is a plastic surgery office that is unique in that we do not aspire to be a practice in which there is a revolving door of patients. Instead, we want to keep it smaller, more personal, and meet the needs of each patient as an individual, getting to know each one and focusing on their care. We hope to reach our goal and reach for our star by adding HRUS to the office.
If you are a patient with questions about your implants, please call us at (614) 569-2649.