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Articles and Stories by Sonia Pressman Fuentes

Sonia Pressman Fuentes

Ruptured Breast Implants

Millions of women in the U.S. have breast implants, which they secured after mastectomies or for cosmetic reasons.  Many of them do not know (1) that they need periodic MRIs to determine if their implants are leaking or ruptured; (2) how to find a facility that has the equipment for performing such MRIs; and (3) what to do if the MRI reveals their implant is leaking or has ruptured.

I had no problems with the silicone gel breast implant in my right breast during the fifteen years after my 1990 mastectomy and simultaneous implant other than its hardening. During those fifteen years, none of the doctors I saw (the surgeon who performed the mastectomy, the plastic surgeon who did the implant, my oncologist, or my internist) ever suggested that (a) I have a test to determine whether the implant was leaking or had ruptured, and (b) if a leak or rupture were found, I consider having the implant removed and replaced.

In the spring of 2005, while I was at my Sarasota, FL, winter residence, I began to notice that my right breast appeared to be growing smaller. Shortly thereafter, I saw an article on CNN.com stating that silicone gel implants had limited life spans and could leak or rupture and advising women to have periodic MRIs to check on their implants.

When I returned to my Potomac, MD, residence in late spring, I researched this matter on the websites of the FDA and the National Research Center for Women & Families, visited my oncologist and plastic surgeon and discussed this matter with the surgeon who performed my mastectomy.

I learned from my research that studies by Dr. Lori Brown and her colleagues at FDA indicated that most women with silicone gel-filled breast implants would have at least one broken implant within 10 years.

The FDA's Web site at that time stated:

“Breast implants do not last a lifetime. Some breast implants rupture/deflate in the first few months after being implanted and some deflate after several years. Others may take 10 or more years to rupture/deflate. . . .

 “As a last note, FDA does not consider mammograms an adequate means of detecting implant rupture/deflation for silicone gel-filled breast implants. As described in the Local Complications & Reoperations (Rupture/Deflation of Silicone Gel-Filled Breast Implants) section above, FDA believes that MRI is currently the best method for detecting implant rupture for silicone gel-filled breast implants.”

Note:  The FDA has a Breast Implant Consumer Handbook with a section on “Local Complications & Reoperations,” based on a study it conducted in June 1999.  It is online at here.

When I mentioned these facts to my doctors, they either expressed ignorance of this information, suggested I have a mammogram before an MRI to check on the condition of the implant, or said that even if the implant were found to be leaking or had ruptured, removal and replacement were not necessarily required as such leaks and ruptures were not harmful, and that the decisions as to whether to remove and replace a leaking or ruptured implant were up to me.

On the issue of whether silicone gel breast implants that are leaking or ruptured should be removed, the website of the National Research Center at http://www.breastimplantinfo.com then stated as follows:

“Can broken implants make me sick?

“According to the FDA’s research, women with leaking silicone implants are more likely to report fibromyalgia (a painful disorder) or several other painful and debilitating diseases. . . .

“What do I do if my implant breaks?

“Most experts agree that it is important to remove a ruptured implant as soon as possible, especially if it contains silicone gel. . . .

“It is important to have ruptured silicone gel implants removed as soon as possible. The longer the silicone is allowed to remain in the body, the more time it has to migrate to other parts of your body, like lungs or lymph nodes, where it can’t be removed. Unfortunately, nobody knows for sure what will happen as a result of silicone in the body because no one has conducted any research on the subject."

I was able to get a prescription for an MRI from one of my doctors and then I had to find a facility qualified to perform such an MRI.

In my research, I learned that Dr. Michael Middleton of San Diego, California, was an expert on using MRIs to detect the leaking and rupture of silicone breast implants. Dr. Middleton suggested I find a facility that:

a) had a 1.5 tesla scanner,

b) had and used a “breast coil,”

c) imaged each breast independently (one at a time),

d) for each breast, performed T2-weighted imaging with water suppression,

and then with silicone suppression, and

e) for each sequence, obtained images at high enough resolution:

minimum: 20 cm FOV, 256 x 256 matrix, 4 mm slice thickness.

I called two facilities in the Washington, D.C., area that did not have this equipment but then I found a third that did and scheduled an MRI for June 1, 2005.

Subsequently, I had the MRI, which showed that my implant had indeed ruptured. 

Thereafter, I consulted several experts for recommendations on a surgeon to remove and replace the implant. All highly recommended Dr. Lu-Jean Feng who has her own clinic in Cleveland, Ohio.  At the end of August 2005, I flew to Cleveland to consult Dr. Feng,  who recommended that I have an ultrasound given by a doctor in Cleveland who specialized in such ultrasounds.  That ultrasound confirmed the diagnosis that the implant had ruptured.  On September 1, in her clinic, Dr. Feng removed the ruptured implant and replaced it with a saline implant. 

That was five years ago and “so far, so good.”

© 2011 by Sonia Pressman Fuentes

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