by Salzman, Marc J.
Plastic and Reconstructive Surgery: January 2022
- Volume 149 - Issue 1 - p 7-14
Background:
Patient compliance has been low for U.S. Food and Drug Administration–recommended
magnetic resonance imaging scans to screen silicone gel breast implants for
silent rupture. High-resolution ultrasound scans are a convenient, in-office
alternative that may improve screening compliance; however, women’s attitudes and
feelings about silent rupture and their desire for rupture screening are
unknown.
Methods:
Plastic surgeons and staff in nine private practices
received 1-day training in high-resolution ultrasound scanning, then screened
women with silicone gel implants implanted since 2000. Suspect scans were
reviewed by a high-resolution ultrasound–experienced plastic surgeon to
determine if they showed ruptures. Surgical and scan findings were correlated.
To learn attitudes and feelings about silent rupture, women took surveys before
and after the scan.
Results:
Of 584 women screened, 82 (14.0 percent) had scans showing
ruptures; of 1153 implants, 92 (8.0 percent) showed ruptures. Forty women with
scans showing ruptures underwent surgery, of which 30 (75 percent) had their
ruptures confirmed. Surveys found 99.5 percent of women want to know if they
have a rupture and 95.2 percent want the ruptured implant removed. If the scan
showed no rupture, women felt relieved and 95.5 percent would get future
high-resolution ultrasound screening for silent rupture. If a rupture was
found, women expressed various concerns and 87.8 percent would remove the
ruptured implant within 12 months.
Conclusions:
Surveys show that women with silicone gel implants have
concerns and feel anxious about possible silent rupture. Based on 14 percent of
women showing a ruptured implant on high-resolution ultrasound scans and 75
percent of ruptures on high-resolution ultrasound scans surgically confirmed,
10.6 percent of women in this study have a silent rupture.
