![]() ![]() When significantly collapsed, it appears as a group of wavy lines, termed the linguine sign 1. When minimally collapsed, it appears as a parallel line to the capsule, termed the subcapsular line sign. In an intracapsular rupture, the contents of the implant are contained by the fibrous scar, while the shell appears collapsed. Often does not require contrast if the indication is solely for this purpose. Breast MRIĬonsidered most sensitive for detection of implant rupture. Ultrasound overall performs poorly, with sensitivity and specificity rates ranging between ~59-85% and ~55-79% respectively 7. Ultrasound may demonstrate a " snowstorm appearance" of an extracapsular rupture or the stepladder sign of an intracapsular rupture (a normal implant should usually be anechoic). Radiographic features Mammographyĭetection of implant ruptures (particularly silicone implant ruptures) are difficult on mammography and detection of intra-capsular silicone ruptures are almost impossible on mammography. An extracapsular rupture implies intracapsular rupture as well 3. Extracapsular ruptureĪn extracapsular rupture can lead to a change in the implant contour and may be detected on clinical examination or mammography. Intracapsular rupture is best seen on MRI. This makes it difficult to detect on clinical exam or mammography. Intracapsular ruptureĪn intracapsular rupture occurs when the shell of the implant ruptures but the fibrous capsule formed by the breast remains intact. Implant ruptures may be intracapsular (~85%) or extracapsular (~15%) 4. PathologyĪfter implantation of a silicone or saline breast implant, a fibrous capsule (scar) forms around the implant shell. It can be intracapsular, when confined by the surrounding fibrous capsule, or extracapsular, when silicone freely extravasates. Breast implant ruptures are a recognized complication of a breast implant.
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