Bookmarks
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Clinical Issues
TERMINOLOGY
Definitions
- Multilumen implants usually double lumen
- Majority have outer saline-filled lumen and inner silicone-filled lumen
- Outer saline shell can be unfilled or filled to varying degree at time of placement
- Saline usually added through valve on shell patch or outer shell; valve is usually posterior
- Expander type may have tubing to port just deep to skin
- When developed, thought was that outer shell could be deflated to minimize contracture symptoms
- Outer lumen size can be changed when patient wants to change implant size
- 2 shell-patch configurations exist
- Shared-back-patch implants have one patch attached to both lumen shells
- Separate-back-patch implants (bag-in-bag configuraton) have 2 patches: Silicone lumen component floats in saline-filled outer lumen
- Outer saline shell can be unfilled or filled to varying degree at time of placement
- Reverse double lumen: Outer lumen silicone, inner saline (uncommon)
- Inner saline lumen gradually filled over months through subcutaneous port
- Fill tube starts in inner lumen, goes through valve on inner lumen shell, then through outer lumen and outer shell value to subcutaneous fill port
- Tube pulled when implant fully inflated
- Most often used for reconstruction, gradually stretching chest wall tissue
- Outer silicone thought to give more natural feel
- Inner saline lumen gradually filled over months through subcutaneous port
- Both lumina silicone: Gel within gel; often with saline mixed with inner silicone
- When saline mixed with silicone, termed "reverse adjustable double-lumen implants"
- Saline placed in inner lumen with silicone; can adjust amount of saline
- When saline mixed with silicone, termed "reverse adjustable double-lumen implants"
- Both lumina saline: Developed to decrease wrinkling and capsular contracture
- Triple lumen: Typically have silicone gel inner and middle lumens and saline outer lumen
- Saline can be added through value on outer shell patch
- Often have keyhole appearance anteriorly between silcone lumina
- Majority have outer saline-filled lumen and inner silicone-filled lumen
- Multilumen implants developed to allow outer saline lumen to be deflated to decrease contracture symptoms and to decrease gel bleed
- Capsule: Scar tissue that body forms around implant
- Multilumen implants usually double lumen
IMAGING
General Features
Mammographic Findings
Ultrasonographic Findings
MR Findings
Imaging Recommendations
CT Findings
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
Gross Pathologic & Surgical Features
CLINICAL ISSUES
Presentation
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
- Expert Panel on Breast Imaging et al: ACR Appropriateness Criteria Breast Implant Evaluation. J Am Coll Radiol. 15(5S):S13-S25, 2018
- Hammond DC et al: Long-term outcomes with the McGhan Style 153 dual-lumen breast implant: Implications for future implant design. J Plast Reconstr Aesthet Surg. 69(9):1211-7, 2016
- Shah AT et al: Imaging of common breast implants and implant-related complications: A pictorial essay. Indian J Radiol Imaging. 26(2):216-25, 2016
- Lavigne E et al: Breast cancer detection and survival among women with cosmetic breast implants: systematic review and meta-analysis of observational studies. BMJ. 346:f2399, 2013
- Nichter LS et al: Two-year outcomes with a novel, double-lumen, saline-filled breast implant. Aesthet Surg J. 32(7):861-7, 2012
- Chien CH et al: Spontaneous autoinflation and deflation of double-lumen breast implants. Aesthetic Plast Surg. 30(1):113-7, 2006
- Brown SL et al: Breast implant adverse events during mammography: reports to the Food and Drug Administration. J Womens Health (Larchmt). 13(4):371-8; discussion 379-80, 2004
- Miglioretti DL et al: Effect of breast augmentation on the accuracy of mammography and cancer characteristics. JAMA. 291(4):442-50, 2004
- Middleton, MS et al. Breast Implant Imaging. Lippincott, Williams and Wilkins. 192-206, 2003
- Sanger JR et al: False-positive radiographic diagnosis of breast implant rupture because of breast abscess. Ann Plast Surg. 42(5):564-7, 1999
- Berg WA et al: Single- and double- lumen silicone breast implant integrity: prospective evaluation of MR and US criteria. Radiology. 197(1):45-52, 1995
- Berg WA et al: MR imaging of the breast in patients with silicone breast implants: normal postoperative variants and diagnostic pitfalls. AJR Am J Roentgenol. 163(3):575-8, 1994
- Lemperle G et al: Effect of cortisone on capsular contracture in double-lumen breast implants: ten years' experience. Aesthetic Plast Surg. 17(4):317-23, 1993
Related Anatomy
Loading...
Related Differential Diagnoses
Loading...
References
Tables
Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Clinical Issues
TERMINOLOGY
Definitions
- Multilumen implants usually double lumen
- Majority have outer saline-filled lumen and inner silicone-filled lumen
- Outer saline shell can be unfilled or filled to varying degree at time of placement
- Saline usually added through valve on shell patch or outer shell; valve is usually posterior
- Expander type may have tubing to port just deep to skin
- When developed, thought was that outer shell could be deflated to minimize contracture symptoms
- Outer lumen size can be changed when patient wants to change implant size
- 2 shell-patch configurations exist
- Shared-back-patch implants have one patch attached to both lumen shells
- Separate-back-patch implants (bag-in-bag configuraton) have 2 patches: Silicone lumen component floats in saline-filled outer lumen
- Outer saline shell can be unfilled or filled to varying degree at time of placement
- Reverse double lumen: Outer lumen silicone, inner saline (uncommon)
- Inner saline lumen gradually filled over months through subcutaneous port
- Fill tube starts in inner lumen, goes through valve on inner lumen shell, then through outer lumen and outer shell value to subcutaneous fill port
- Tube pulled when implant fully inflated
- Most often used for reconstruction, gradually stretching chest wall tissue
- Outer silicone thought to give more natural feel
- Inner saline lumen gradually filled over months through subcutaneous port
- Both lumina silicone: Gel within gel; often with saline mixed with inner silicone
- When saline mixed with silicone, termed "reverse adjustable double-lumen implants"
- Saline placed in inner lumen with silicone; can adjust amount of saline
- When saline mixed with silicone, termed "reverse adjustable double-lumen implants"
- Both lumina saline: Developed to decrease wrinkling and capsular contracture
- Triple lumen: Typically have silicone gel inner and middle lumens and saline outer lumen
- Saline can be added through value on outer shell patch
- Often have keyhole appearance anteriorly between silcone lumina
- Majority have outer saline-filled lumen and inner silicone-filled lumen
- Multilumen implants developed to allow outer saline lumen to be deflated to decrease contracture symptoms and to decrease gel bleed
- Capsule: Scar tissue that body forms around implant
- Multilumen implants usually double lumen
IMAGING
General Features
Mammographic Findings
Ultrasonographic Findings
MR Findings
Imaging Recommendations
CT Findings
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
Gross Pathologic & Surgical Features
CLINICAL ISSUES
Presentation
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
- Expert Panel on Breast Imaging et al: ACR Appropriateness Criteria Breast Implant Evaluation. J Am Coll Radiol. 15(5S):S13-S25, 2018
- Hammond DC et al: Long-term outcomes with the McGhan Style 153 dual-lumen breast implant: Implications for future implant design. J Plast Reconstr Aesthet Surg. 69(9):1211-7, 2016
- Shah AT et al: Imaging of common breast implants and implant-related complications: A pictorial essay. Indian J Radiol Imaging. 26(2):216-25, 2016
- Lavigne E et al: Breast cancer detection and survival among women with cosmetic breast implants: systematic review and meta-analysis of observational studies. BMJ. 346:f2399, 2013
- Nichter LS et al: Two-year outcomes with a novel, double-lumen, saline-filled breast implant. Aesthet Surg J. 32(7):861-7, 2012
- Chien CH et al: Spontaneous autoinflation and deflation of double-lumen breast implants. Aesthetic Plast Surg. 30(1):113-7, 2006
- Brown SL et al: Breast implant adverse events during mammography: reports to the Food and Drug Administration. J Womens Health (Larchmt). 13(4):371-8; discussion 379-80, 2004
- Miglioretti DL et al: Effect of breast augmentation on the accuracy of mammography and cancer characteristics. JAMA. 291(4):442-50, 2004
- Middleton, MS et al. Breast Implant Imaging. Lippincott, Williams and Wilkins. 192-206, 2003
- Sanger JR et al: False-positive radiographic diagnosis of breast implant rupture because of breast abscess. Ann Plast Surg. 42(5):564-7, 1999
- Berg WA et al: Single- and double- lumen silicone breast implant integrity: prospective evaluation of MR and US criteria. Radiology. 197(1):45-52, 1995
- Berg WA et al: MR imaging of the breast in patients with silicone breast implants: normal postoperative variants and diagnostic pitfalls. AJR Am J Roentgenol. 163(3):575-8, 1994
- Lemperle G et al: Effect of cortisone on capsular contracture in double-lumen breast implants: ten years' experience. Aesthetic Plast Surg. 17(4):317-23, 1993
