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You might have heard from someone or read online various recommendations regarding the need for MRI of your breasts every few years following the insertion of silicone breast implants such as for breast enlargement, breast lift with implants or breast reconstruction. If you recently had silicone implants placed or are considering them for cosmetic or reconstructive breast surgery, you may be wondering whether or not this is really true and definitely needed or just more unfounded, internet facilitated “information”.

Let me clarify this situation for you. Starting back in 2006 when the FDA (Federal Drug Administration) again allowed unrestricted (essentially) usage of silicone breast implants for both cosmetic and reconstructive procedures, their “recommendations” were:

Screen for silent rupture using MRI. Women with silicone gel-filled breast implants
should undergo MRI screening for silent implant ruptures at 3 years post-implantation,
and every 2 years thereafter.

Like many government edicts, this is not without considerable financial consequences. Many insurance companies will not authorize (cover) an MRI of the breasts for women who have no symptoms. This is even more likely if the surgery was for a breast augmentation as compared to breast reconstruction. The cost of an MRI paid out of pocket for those with no insurance coverage can range from over $500 to in excess of $2000.

You are surely thinking: “Do I really need to have MRI of my breasts regularly?” as well as the expected: “Will my insurance cover this because, if not, I can’t afford to have them done as they are too expensive?”

Is there evidence to support this recommendation/edict by the FDA?

In short, the answer is NO.

Clinical research conducted by plastic surgeons at Memorial Sloan-Kettering Cancer Center in New York and published in the Plastic and Reconstructive Surgery journal clearly does not support this recommendation. They note that there is no conclusive evidence that screening MRI results in a reduction in patient morbidity or that the benefits of interval screening outweigh the risks which do include false positive results that can lead to unnecessary surgery. From my personal experience, I have had several asymptomatic patients (all breast reconstruction) whose MRI at 5 years indicated a ruptured implant leading to surgery whereupon the implants were found to be entirely intact and pristine (a false positive reading).

Evidence and experience supports the approach of obtaining MRI during the first 10 years after implantation only when the patient is experiencing certain symptoms or physical findings. Ultimately, it may be a judgment call on the part of the plastic surgeon or other physician in determining the prudence and necessity of obtaining a MRI particularly when it is not covered by insurance.

For more information on silicone breast implants, breast augmentation or breast reconstruction, please call my office at 480-451-3000.

Steven H. Turkeltaub, M.D. P.C.
Scottsdale and Phoenix, Arizona

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A Message Regarding Coronavirus/COVID-19

In light of the coronavirus/COVID-19 pandemic, we would like to let you know of some of the major precautions we are taking in our office to maximize cleanliness and keep the environment as sanitary and safe as possible. Our highest priority is always to ensure the safety of every individual who sees us and we are taking extreme infection-control measures to maintain cleanliness and “sterility” of surfaces and the overall environment.

We will be limiting dates and times for office appointments and consultations due to safety and other issues. Consequently, if you have already made an office appointment or consultation prior to March 18, 2020 to occur at a later time, this may need to be changed.

For anyone considering plastic surgery, we are now offering Virtual Consultations and Telemedicine through Skype. A great number of aesthetic or insurance-related issues can be evaluated via pictures and online video conferencing, making this an excellent way to find out more about particular procedures, determine candidacy for treatment, receive answers to questions and facilitate being able to move forward with care once the government lifts all restrictions.

In an abundance of caution, we are asking all current patients who are experiencing a fever, cough, chills, fatigue or any type of respiratory illness to please delay any upcoming appointments at our practice. We can talk with you by phone or email to establish a new date and time for the appointment.

We are all in this together. Our team urges everyone to follow the guidelines recommended by local health authorities and the Centers for Disease Control and Prevention, which include frequent handwashing for a minimum of 20 seconds, social distancing, staying home if you are feeling sick, and contacting your healthcare provider if you feel you are experiencing symptoms.

For more information, please read our blog – Coronavirus and You: Important Information

For further updates, please check our blog.

If you have any questions or concerns, please contact us by phone or email.