Journal List > J Korean Surg Soc > v.80(2) > 1011275

Lee, Kim, and Han: Rupture of the Cohesive Silicone Gel Implant after Breast Augmentation



Breast augmentation with cohesive silicone gel implant has been popular but there remains the risk of implant rupture. We investigated the diagnosis and treatment of cohesive gel implant rupture.


Ten cases of cohesive gel implant rupture between August 2006 and August 2010 in ooo were reviewed in this study. The diagnostic role of Magnetic resonance imaging (MRI) and ultrasonography (US), and operative findings of cases were studied retrospectively.


The mean interval from previous surgery was 14.7 months ranging from 3 to 44 months. Nine cases were visited due to abrupt changes in texture of implants and 1 case for revision of capsular contracture. Seven of 10 cases had capsular contracture, simultaneously. We diagnosed the first case by US and MRI but only US was used in the other 9 cases. US showed discontinuity of the implant membrane and multiple parallel echogenic lines within the implant interior (stepladder sign), and MRI showed the presence of multiple curvilinear low-signal-intensity lines seen within the high-signal-intensity silicone gel (linguine sign). All the ruptured gel remained in place within the capsule and did not migrate into the surrounding area. Surgeries were implant replacement in 3, replacement with capsulectomy in 6 with capsular contracture, and subpectoral conversion with capsulectomy and mastopexy in 1 case.


US without MRI has asatisfactoryrole in the screening method for detection of cohesive silicone gel implant rupture in symptomatic cases. Ruptured implants were removed and replaced easily due to their highly cohesive nature.


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Fig. 1.
Ultrasonography showed discontinuity of the implant membrane and multiple parallel echogenic lines within the implant interior (stepladder sign).
Fig. 2.
MRI showed the presence of multiple curvilinear low-sig-nal-intensity lines seen within the high-signal-intensity silicone gel (linguine sign).
Fig. 3.
Ruptured gel was highly cohesive and removed completely.
Fig. 4.
Table 1.
Demography of patients
Case No. Age (year) Time to rupture (month) US* MRI Contracture Implant volume (cc) Simultaneous capsulectomy Rupture type
1 28 12 Yes Yes Yes 225 Yes Intracapsular
2 26 10 Yes No No 225 No Intracapsular
3 25 14 Yes No No 250 No Intracapsular
4 41 12 Yes No Yes 250 Yes Intracapsular
5 29 12 Yes No No 275 No Intracapsular
6 34 5 Yes No Yes 250 Yes Intracapsular
7 32 24 Yes No Yes 300 Yes Intracapsular
8 37 3 Yes No Yes 225 Yes Intracapsular
9 30 44 Yes No Yes 250 Yes Intracapsular
10 24 11 Yes No Yes 190 Yes Intracapsular

* US = ultrasonography;

MRI = magnetic resonance imaging.

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