Breast implants
Citation, DOI & article data
- Mammary prostheses
- Mammary prosthesis
- Breast prosthesis
- Breast prostheses
- Breast implant
- Mammary implants
- Mammary implant
Breast implants are increasingly common in general breast radiology practice.
On this page:
Classification
Location
Breast implants may be placed behind the glandular tissue but in front of the pectoral muscle:
- subglandular
- submammary
- retroglandular
- retromammary
The second position of breast implants is behind the pectoral muscle; this has been termed subpectoral or retropectoral.
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 and rotated latissimus dorsi muscle (so-called LADO-FLAP).
Surgical access
There are multiple options regarding the surgical access for placing the breast implant. Selection of access is primarily based on the implant size, type and location. Furthermore, skin quality, residual breast tissue and body habitus also influence the decision for the used surgical access. Prior breast surgery or breast deformities (e.g. Poland syndrome) limit the possible options. The typical access ways are:
- inframammary (most common)
- periareolar
- transaxillary
- transumbilical
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 the 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 the 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 hematoma
- infection
- breast implant failure
- breast implant-associated anaplastic large cell lymphoma (rare) 6
- axillary lymph nodes siliconoma
Differential diagnosis
Occasionally on plain chest radiographs, other pathologies may mimic the breast implant appearance:
- lung cancer - see differential case
Quiz questions
References
- 1. Middleton MS, Mcnamara MP. Breast implant classification with MR imaging correlation: (CME available on RSNA link) Radiographics. 2000;20 (3): E1. Radiographics (full text) - Pubmed citation
- 2. Eurorad teaching files : Case 8831
- 3. Debruhl ND, Gorczyca DP, Ahn CY et-al. Silicone breast implants: US evaluation. Radiology. 1993;189 (1): 95-8. Radiology (abstract) - Pubmed citation
- 4. Berg WA, Caskey CI, Hamper UM et-al. Diagnosing breast implant rupture with MR imaging, US, and mammography. Radiographics. 1993;13 (6): 1323-36. Radiographics (abstract) - Pubmed citation
- 5. Paredes ES. Atlas of mammography. Lippincott Williams & Wilkins. (2007) ISBN:0781764335. Read it at Google Books - Find it at Amazon
- 6. Leberfinger AN, Behar BJ, Williams NC, Rakszawski KL, Potochny JD, Mackay DR, Ravnic DJ. Breast Implant-Associated Anaplastic Large Cell Lymphoma: A Systematic Review. (2017) JAMA surgery. 152 (12): 1161-1168. doi:10.1001/jamasurg.2017.4026 - Pubmed
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