Question: Do breast implants interfere with mammography and can a mammogram injure the implants?
Answer: This is a question that I address with all of my breast implant patients. The answer depends upon whether the implant is surgically placed above or below the pectoralis (chest) muscle. Most of the time in very small- or medium-sized candidates for breast augmentation (A and B cups), the implants are placed beneath the chest muscles. This actually allows the patient’s breast to be more easily mammogramed. The implant pushes the natural breast away from the ribs, allowing the mammographer to get better compression and view of the breast. Many small- breasted women (A cups) are virtually impossible to mammogram because the tissue cannot be compressed between the x-ray plates. Occasionally, a patient will opt for an implant above the chest muscles but beneath the breast gland (subglandular). This placement is generally used for patients who have slight sagging of the breasts (ptosis) and do not want to have a breast lift (mastopexy).In this case, the implant obscures a percentage of the breast. Breast implants are radiopaue, which means the mammogram rays cannot see through them. In this case, a maneuver called an Ekland is performed, to push the implant away from the breast tissue so that it obscures less tissue. Even with this maneuver though, some tissue will not be seen. This is important information for a patient to understand prior to surgery and it is valuable for a patient to understand the placement of their implants for future reference. Although I have never seen or heard of an implant being damaged during routine mammography, saline implants do have a leakage rate of less than 1%, so it cannot be ruled out entirely as a possibility. As always, it is important to find a physician with significant experience and training in cosmetic surgery with whom to discuss all options.
