If you have cosmetic breast implants—saline or silicone—you generally continue age- and risk-appropriate mammography. After mastectomy with implant reconstruction, routine mammography of that side may not be needed, so follow the plan from your breast team. Any new lump, skin change, or implant symptom still needs assessment.
This guide walks through what is different about a mammogram with implants, the safety of the procedure for the implant itself, and what additional imaging your doctor may suggest.
Do implants affect what a mammogram can see?
Yes — implants block X-rays, so the breast tissue behind and to the sides of the implant is hidden on a standard mammogram view. To see around them, the mammographer takes two sets of images:
- Standard views: Two views of each breast with the implant in place. These show the front layers of breast tissue.
- Eklund (implant displacement) views: The mammographer gently pushes the implant back toward the chest wall while pulling the breast tissue forward over the compression plate. This brings the natural tissue into view without compressing the implant itself.
Additional implant-displacement views are usually taken when they are technically possible. The exact number and type of images depend on implant position, symptoms, previous surgery, and the mammographer's judgement.
What happens during the procedure?
- You undress from the waist up and put on a gown.
- The mammographer asks where your implants are placed — most are behind the breast tissue but in front of the chest muscle (subglandular), while some are behind the muscle (submuscular). Submuscular implants are usually easier to image around.
- Standard views are taken first.
- For the Eklund views, the mammographer carefully manipulates the implant backward and the breast tissue forward. This step takes a little longer than a routine mammogram.
- Compression is firm but gentle. The mammographer is trained not to over-compress the implant.
The whole appointment usually takes 25 to 40 minutes — a bit longer than a standard screening exam.
Can compression damage my implant?
Implant rupture from a mammogram is very rare
Implant rupture during mammography has been reported but appears uncommon. Tell the centre about your implants when booking and report pain, a known or suspected rupture, recent surgery, or capsular contracture before compression so the team can choose the safest approach.
If you have any current implant pain, recent surgery, or a concern about a leak, tell the mammographer before the exam so they can adjust the pressure and consider whether a different imaging test is more appropriate first.
Do I need to prepare differently because I have implants?
Preparation is the same as any mammogram:
- No fasting is required.
- Avoid deodorant, perfume, lotion, or powder on your chest and underarms.
- Wear a two-piece outfit.
- Tell the imaging centre when you book that you have implants, so they can allocate extra time and assign a mammographer experienced with Eklund views.
- Bring your implant surgery records if you have them. Knowing the year, type, and placement helps both the mammographer and the radiologist.
Will the mammogram show problems with the implant itself?
A mammogram is mainly for finding cancer in breast tissue, not for testing implant integrity. Ultrasound or MRI is more useful when silicone implant rupture is suspected. Surveillance recommendations vary by implant type, symptoms, manufacturer, and local practice, so use the written plan from your surgeon or breast team rather than treating a foreign regulator's timetable as a Nigerian screening rule.
Are there extra screening tests if I have implants?
Ultrasound or MRI may be added for a symptom, implant-integrity question, dense tissue, or high cancer risk, but implants alone do not automatically require both tests. The choice should match the clinical question.
Is the radiation dose higher because there are more views?
Additional views can increase the total dose, but it is not accurate to assume it will be exactly double. The dose depends on breast thickness, equipment, technique, and the images needed. When mammography is justified, the benefit generally outweighs the small radiation risk.
What if my centre is not experienced with implant mammograms?
Implant mammography is a specific technique that requires training and practice. If you have implants, ask the imaging centre when you book whether their mammographers are trained in Eklund views. A centre that does this routinely will say so without hesitation. If the answer is unclear, consider a centre with more volume.
Questions to ask your care team
- Does this centre routinely perform implant-displacement views?
- Is the test for cancer screening, an implant problem, or both—and is ultrasound or MRI also needed?
- What symptoms after the examination should prompt me to contact the centre?
- If I develop a new lump, one-sided bloody or clear nipple discharge, skin or nipple pulling, or persistent redness, where should I be assessed promptly?
Sources and further reading
- FDA: Mammography—what you need to know
- FDA: Mammography Quality Standards Act patient FAQ
- WHO: Breast cancer
Conclusion
Cosmetic implants usually do not remove the need for age- and risk-appropriate cancer screening, although they can obscure tissue and require specialised views. Tell the centre when booking, choose an experienced mammographer, and distinguish cancer screening from implant-integrity imaging. After mastectomy and reconstruction, follow the individual plan from your breast team.