Breast implants

Breast implants are increasingly common in general breast radiology practice.

Classification

Location

Breast implants may be placed behind the glandular tissue but in front of the pectoral muscle :

• sub-glandular
• sub-mammary
• retro-glandular
• retro-mammary

The second position of breast implants is behind the pectoral muscle; this has been termed sub-pectoral or retro-pectoral.

In women who have implants placed after mastectomy, the implant may be placed behind the pectoralis muscle. Augmentation can also be done by using an implant a rotated latissimus dorsi muscle (so-called LADO-FLAP).

Types

The implants may be composed of saline, silicone or a combination of both.

They come in a variety of types including:

• single-lumen gel 
  • silicone gel-filled
• single-lumen adjustable
  • silicone gel-filled, to which can be added a variable amount of saline at time of placement
• saline-filled, dextran-filled, PVP-filled
  • dextran-filled (some early implants), PVP-filled (Bioplasty), and the rest saline-filled
• standard double-lumen
  • silicone gel inner lumen, saline outer lumen
• reverse double-lumen
  • saline inner lumen, silicone gel outer lumen
• reverse-adjustable double-lumen
  • silicone gel inner and outer lumens, variable amount of saline added to inner lumen at time of placement
• gel-gel double-lumen
  • silicone gel inner and outer lumens
• triple-lumen
  • silicone gel inner and middle lumens, saline outer lumen

Complications

• breast implant rupture
• breast implant collapse : typically occurs with saline implants and is also sometimes considered a type of rupture
• breast implant herniation
• capsular contracture : 
  • the capsule contracts making the implant hard to palpate and may cause pain
  • considered one of the commonest complications 
• implant associated haematoma
• infection
• breast implant failure

See also

• linguine sign