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In a new report on safety of silicone gel–filled breast implants, the FDA has recommended that women should undergo surveillance with breast magnetic resonance imaging (MRI) to detect silent ruptures 3 years after implant placement and every 2 years thereafter. In 2010, almost 300,000 U.S. women underwent breast augmentation. Although breast MRIs are considered state-of-the-art for detecting occult leaks in silicone implants, many insurance plans do not cover such MRIs; thus, out-of-pocket costs are substantial.
Should we advise our asymptomatic patients with silicone breast implants to undergo regular MRI surveillance? Perhaps not. Evidence to support such screening is lacking (Plast Reconstr Surg 2008; 121:1127): No conclusive results indi…