Intracapsular breast implant rupture

Case contributed by Dr Rubens Ribeiro de Souza

Presentation

Possible intracapsular breast implant rupture on previous ultrasound.

Patient Data

Age: 40 years
Gender: Female

Multiple hyperintense foci on T2-weighted images and multiple hypointense foci on water-suppression images within the implant lumen. These findings are referred to as the “salad oil sign” or “droplet sign”.
There is silicone between the shell and the fibrous capsule but no evidence of free silicone extending beyond it.

Subtle silicone invagination between the inner shell and fibrous capsule (teardrop / key-hole sign).

The images findings are suggestive of intracapsular breast implant rupture.

Simple cysts randomly distributed through both breasts, no bigger than 9mm.

Case Discussion

MRI is a great tool for diagnosis of intracapsular breast implant ruptures and is also the most accurate technique for differentiating intracapsular from extracapsular rupture as it can show silicone leakage into the breast parenchyma in extracapsular cases.

While extracapsular rupture is also frequently associated with “linguine sign”, intracapsular rupture may be associated with other non-specific imaging signs such as the “salad oil sign”, as observed in this case.

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