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Intracapsular breast implant rupture

Case contributed by 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 or inclusion bodies on fat saturation 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 image findings are suggestive of intracapsular breast implant rupture.

Incidental note made of simple cysts randomly distributed through both breasts.

Case Discussion

MRI is a great tool for diagnosis of intracapsular breast implant failure 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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