Breast Implants Flashcards
Are cosmetic implants typically subglandular or submuscular?
Subglandular AKA prepectoral
What implant location are primarily for placement of tissue expanders or following a mastectomy?
Submuscular or retropectoral
What type of implant fluid has a single anechoic lumen and an anterior filling port to allow fluid expansion?
Saline
What are the most common type of silicone implant?
Single lumen - come in prefilled sizes
What are the two main types of silicone implants?
- Single lumen - prefilled
- Double lumen - Has separate silicone and saline chambers and an echogenic membrane separates the chambers
What is contained in a double lumen silicone implant vs. a single lumen?
A saline portion with a filling port
As response to a foreign object in the body, what will form around the implant?
Fibrous capsule
What type of implant will have a more pronounced fibrous capsule?
Silicone
What is the specific term used for the sonographic appearance of an implant?
Capsule-shell-echo complex - 2 smooth echogenic lines with an adjacent fibrous capsule (3 echogenic lines)
What type of artifact creates a band of false echoes across the anterior lumen of the implant?
Reverb artifact
What type of artifact creates a band of false echoes across the anterior lumen of the implant?
Reverb artifact
Explain the propagation speed artifact with silicone implants.
Beams travel through silicone at 1000m/s (slower than through soft tissue), placing structures behind the implant DEEPER in the body than they actually are
T or F? Linear infolding of an implant seen on ultrasound is normal?
TRUE - may mimic a double lumen implant or intracapsular rupture
What is it called when you see reactive fluid between the shell & the fibrous capsule of an implant?
Peri-implant effusion
What is capsular contracture?
When the capsule becomes hardened and thickened and immobile
In what type of implant is capsular contracture more common?
Silicone
Capsular contracture is thought to be due to what?
Excessive reaction to the foreign body response from the implant
Name the 3 main implant complications and what they are.
- Capsular contracture - thickening and hardening of the capsule
- Focal herniation - a crack/defect in the implant that leaks fluid
- Peri-implant seroma abscess or hematoma - due to implant surgery, trauma, infection
What two tests are most sensitive to SILICONE determining implant integrity over time?
- MRI
- Sonography
What type of implant is more commonly susceptible to rupture?
Saline
Why can x-ray visualize saline implants but not silicone?
Silicone blocks x-ray penetration
Silicone implant failure is known to cause what two kinds of rupture?
- Intra-capsular rupture (ICR)
- Extra-capsular rupture (ECR)
What is the most common type of silicone implant rupture?
INTRA-capsular - contained within the fibrous capsule
What is the main difference between an intra- and extra-capsular rupture?
ICR - contained within the fibrous capsule
ECR - not contained
What sign on sonography is associated with significant silicone ICR?
“Step-ladder” sign
What sign on MRI is associated with silicone ICR?
Linguine sign
What classifies an ECR in a silicone implant?
- Defect in both the implant shell AND fibrous capsule - fluid leaks into the surrounding breast tissue and can be taken up by nearby lymph nodes
What is the common sonographic appearance of an ECR?
“Echogenic noise” sign or “snowstorm” appearance
