By Dr. Killeen, published on December 8, 2025
An expert clinician can diagnose things that you may not notice as a patient because it's happening slowly.
No — saline implants do not have the same imaging recommendations as silicone implants. But that doesn't mean they don't need monitoring.
Silicone implants can have what's called a silent rupture — the implant breaks, but you won't know right away because the silicone gel stays contained within the capsule. Over time, this can lead to problems like capsular contracture, but there are often no immediate symptoms. That's why regular imaging (MRI or ultrasound) is recommended starting at five years.
When a saline implant ruptures, you typically know right away because the implant goes flat. The saline (salt water) is safely absorbed by your body. Since the rupture is obvious, routine imaging isn't necessary to detect it.
Even without imaging requirements, it's still very important to have regular exams with an experienced clinician. Here's why:
During the period when silicone implants were off the market (1992–2006), everyone was getting saline implants. Many of those were placed through areolar or axillary incisions, which carry a much higher risk of capsular contracture. Dr. Killeen finds that in her area, contracture rates for these older saline implants are actually quite high.
The changes that come with capsular contracture and other breast implant problems happen slowly — over months or years. As a patient, you may not even notice because it's so gradual. An expert clinician can diagnose things you might miss, which is one of the best reasons to keep up with follow-up appointments even when you feel fine.
It's important that your clinician properly documents what your implant feels like at each visit. If it feels different next year, that change can be caught early and addressed. A contracture caught at a mild stage is a much easier and less expensive problem to manage than a severe one.
No imaging is required for saline implants the way it is for silicone — but regular follow-up with an expert who examines and documents your implant status is still essential. Early detection of problems like contracture makes treatment simpler and outcomes better.