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).
Surgical access
There are multiple options regarding the surgical access for placing the breast implant. Selection of an 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 haematoma
- infection
- breast implant failure
Related articles
Breast imaging and pathology
- breast screening
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mammography
- breast imaging and the technologist
- forbidden (check) areas in mammography
-
mammography views
- craniocaudal view
- mediolateral oblique view
- additional (supplementary) views
- true lateral view
- lateromedial oblique view
- late mediolateral view
- step oblique views
- spot view
- double spot compression view
- magnification view
- exaggerated craniocaudal (axillary) view
- cleavage view
- tangential views
- caudocranial view
- bullseye CC view
- rolled CC view
- elevated craniocaudal projection
- caudal cranial projection
- 20° oblique projection
- inferomedial superolateral oblique projection
- Eklund technique
- normal breast imaging examples
- digital breast tomosynthesis
- breast ultrasound
- breast ductography
- breast MRI
- breast morphology
- breast pathology
- malignant lesions
-
breast cancer
- breast adenocacrinoma
- ductal breast carcinoma
- ductal carcinoma in situ (DCIS)
- invasive ductal carcinoma
- lobular breast carcinoma
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- adenoid cystic carcinoma of the breast
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- male breast cancer
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- metastases to the breast
- metaplastic carcinoma the breast
- gamuts
- breast adenocacrinoma
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breast cancer
- borderline breast disease / high risk breast lesion
- benign lesions
- adenosis of the breast
- benign papillary lesions of the breast
- breast cyst
- breast haematoma
- breast hamartoma
- breast lipoma
- ductal adenoma of the breast
- epidermal inclusion cysts of the breast
- fat necrosis of the breast
- fibroadenoma
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- gynaecomastia
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breast calcifications (approach)
- morphology
- distribution
- location
- lobular calcification within breast tissue
- intraductal calcification within breast tissue
- milk of calcium within a breast cyst
- vascular calcification in breast tissue
- skin (dermal) calcification in / around breast tissue
- suture calcification within breast tissue
- stromal calcification within breast tissue
- artifactual calcification from outside the breast
- suspicious breast calcifications
- infection/inflammation
- vascular lesions
- systemic disease
- gamuts
- classification systems
- malignant lesions
- breast cancer staging
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