Ultrasound Analysis of 150 Patients with Silicone Gel Breast Implants

Abstract

One-hundred fifty patients with silicone gel breast implants were investigated using ultrasound (US) studies, to assess the integrity of their implants. US testing demonstrated 8 patients (5.33%) with implant rupture, which was subsequently confirmed at surgery. A further 4 patients were "false negatives," wherein they presented with normal US tests, but at subsequent surgery, demonstrated secondary alterations in their implant envelopes. Two of these patients demonstrated profound local silicone gel "bleed," whereas the 2 others had frank implant rupture. There was also one "false positive" patient. The total known prevalence of patient implant alteration was therefore 12, i.e., 10 with ruptures and 2 with profound local gel "bleed," in 150 patients (8.0%). Five of the 10 patients with ruptured implants had undergone multiple closed capsulotomies in the past. The mean time of diagnosis after implant insertion was 8.5 years (range, 2.0-18 yr). US analysis may provide a safe, simple, inexpensive, noninvasive tool to assist in the identification of ruptured silicone gel breast implants. There were significant limitations with technique, however, in that there were 4 false negatives, and 1 false positive result, and US analysis was not helpful in diagnosing profound silicone gel bleeds.