Rupture of the Cohesive Silicone Gel Implant after Breast Augmentation

Sangdal Lee; Sung Hoon Kim; Boo-Kyung Han

doi:10.4174/jkss.2011.80.2.96

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

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

Original Article

Journal of Korean Spine Surg 2011;80(2):96-102.

Published online: 4 February 2011

DOI: https://doi.org/10.4174/jkss.2011.80.2.96

Rupture of the Cohesive Silicone Gel Implant after Breast Augmentation

Sangdal Lee, M.D., Ph.D., Sung Hoon Kim, M.D., Boo-Kyung Han¹

MD Clinic, Sungkyunkwan University School of Medicine, Seoul, Korea

¹Department of Radiology, Sungkyunkwan University School of Medicine, Seoul, Korea

Received 26 October 2010 Accepted 21 December 2010

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

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.

Methods

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.

Results

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.

Conclusion

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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Keywords: Rupture, Cohesive silicone gel, Breast implant

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Fig. 1.

Ultrasonography showed discontinuity of the implant membrane and multiple parallel echogenic lines within the implant interior (stepladder sign).

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Fig. 2.

MRI showed the presence of multiple curvilinear low-sig-nal-intensity lines seen within the high-signal-intensity silicone gel (linguine sign).

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Fig. 3.

Ruptured gel was highly cohesive and removed completely.

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Fig. 4.

Capsulectomy.

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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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