Breast Augmentation with Implants

Each year, approximately 300,000 new implantations are performed in the USA, primarily for aesthetic enhancement (70–80%), with a smaller number for reconstructive purposes following mastectomy or for correcting congenital deformities such as Poland syndrome. The understanding of the use, types, and imaging techniques for breast implants is therefore important. Implants are differentiated by the compartments (either unicompartmental or bicompartmental), shape (round or anatomical), filler material (silicone or saline), and envelope surface (smooth, microtextured, or macrotextured). This chapter thoroughly discusses specific imaging protocols tailored for implant patients, including modified mammography techniques (Eklund technique), ultrasound, MRI protocols (“silicone only” sequence), and biopsies, essential for assessing implant integrity and identifying complications. Key complications such as implant rupture (intracapsular or extracapsular), capsular contracture, seroma formation, implant rotation, herniation, and silicone lymphadenopathy are detailed, with descriptions of their imaging characteristics. The risk of anaplastic large cell lymphoma associated with textured implants is also addressed. Overall, this chapter acts as a comprehensive guide to understanding the complexities of breast implants, stressing the importance of precise imaging techniques. It ensures that healthcare providers are equipped with the knowledge necessary for effective patient management and the mitigation of risks associated with implant procedures.