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Breast implants are increasingly common in general breast radiology practice.
Breast implants may be placed behind the glandular tissue but in front of the pectoral muscle:
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).
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)
The implants may be composed of saline, silicone or a combination of both.
They come in a variety of types including:
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
silicone gel inner lumen, saline outer lumen
saline inner lumen, silicone gel outer lumen
silicone gel inner and outer lumens, variable amount of saline added to inner lumen at the time of placement
silicone gel inner and outer lumens
silicone gel inner and middle lumens, saline outer lumen
breast implant collapse: typically occurs with saline implants and is also sometimes considered a type of rupture
the capsule contracts making the implant hard to palpate and may cause pain
considered one of the commonest complications
axillary lymph nodes siliconoma
late periprosthetic seroma
gel bleed phenomenon: not considered a true complication
Occasionally on plain chest radiographs, other pathologies may mimic the breast implant appearance:
lung cancer - see differential case
- 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
- 7. Bengtson B, Brody G, Brown M et al. Managing Late Periprosthetic Fluid Collections (Seroma) in Patients with Breast Implants: A Consensus Panel Recommendation and Review of the Literature. Plast Reconstr Surg. 2011;128(1):1-7. doi:10.1097/PRS.0b013e318217fdb0 - Pubmed