The number of women undergoing breast implant procedures is increasing rapidly. Especially, correction of congenital malformations, reconstruction after mastectomy and cosmetic augmentation.
It is, therefore, imperative for the plastic surgeon to possess the right tools to evaluate implant integrity, detect abnormalities of the implant and its surrounding capsule, and to detect breast conditions unrelated to implants.
The use of a linear ultrasound scanner allows the practitioner to surpass challenges such as the identification of the type of the implant, diagnosis of implant-related complications, as well as the diagnosis and follow-up of additional breast lesions such as cancer.
With the help of an ultrasound device with high frequency from 7 to 10 MHz, the surgeon can make his evaluation of breast implants, including assessing the morphology, contour, content, and peri-implant tissues and axillae.
The transverse to longitudinal ratio of the implant is calculated; the smooth undulations of the envelope (radial folds), the homogeneity of the implant lumen and signs of free silicone or silicone granulomas in the axillae or breast tissue are all checked.
The implant shell may be seen as a single echogenic line or parallel echogenic lines. The fibrous capsule is visualized as two parallel echogenic lines superficial to the implant surface. Normal undulations of the envelope may be seen as wavy echogenic lines with or without minimal intervening fluid.
Ultrasound is also needed for post-surgical complications, which can be an infection and hematoma, capsular contracture, implant rupture and gel bleed.
Ultrasound (USG) may reveal an abscess visualized as irregular hypoechoic fluid collection with internal debris. USG can also be used to demonstrate the hematoma.
Further, ultrasound detects silicone implant rupture with a sensitivity and the most reliable sign of intracapsular rupture is the visualization of multiple linear or curvilinear lines traversing through the interior of the implant at various levels, termed the “stepladder”.
Breast implant assessment is typically done by a plastic surgeon or a radiologist.
Reference: Imaging of common breast implants and implant-related complications: A pictorial essay.
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Disclaimer: Although the information we provide is used by different doctors and medical staff to perform their procedures and clinical applications, the information contained in this article is for consideration only. SIFSOF is not responsible neither for the misuse of the device nor for the wrong or random generalizability of the device in all clinical applications or procedures mentioned in our articles. Users must have the proper training and skills to perform the procedure with each ultrasound scanner device.
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