Magnetic resonance imaging has become the state-of-art technique to di
agnose the loss of silicone gel-filled mammary implant integrity (rupt
ure, gel leak). In a series of 39 patients considering implant removal
(40 procedures, 74 devices), the impact of magnetic resonance imaging
on the decisions made by the patient and surgeon was examined. In thi
s selected group of patients, implant rupture or gel leak was found in
17 patients (16 grossly ruptured devices and 7 with gel leak). In 9 (
53%) of these patients, magnetic resonance imaging was the decisive fa
ctor leading to the request for explantation by the patient. Diagnosis
of implant rupture based on history and physical examination was made
in 4 patients (confirmed in 3 and negated by magnetic resonance imagi
ng and intraoperatively in 1). In 10 of the 14 remaining patients (26%
) with ''unexpected'' loss of implant integrity (negative history and
physical examination), magnetic resonance imaging evidence was the dec
isive factor for advising explantation by the surgeon. Negative magnet
ic resonance imaging results did not influence the patient's or surgeo
n's decisions. Magnetic resonance imaging appears to be a sensitive an
d specific technique, and there were no false-negative and one false-p
ositive (gel-leak diagnosis) findings in this series.