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
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
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
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
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
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Related Differential Diagnoses
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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
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
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
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
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
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
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