Ultrasound imaging of breast implants: A pictorial essay demonstrating normal morphology and implant related complications

Objective: Ultrasound imaging is widely used for screening of breast implants. It is an inexpensive and reasonably reliable tool in the hands of good ultrasound operators. As breast implants are not infrequently encountered in clinical practice, the sonographers and radiologists should be familiar with and competent in recognizing normal morphology and implant related complications.

We aim to demonstrate these features in our educational poster.

Materials and methods: A selection of breast implant ultrasound images seen in our institution are organized and curated for this purpose. The common types of implants, site of implantation, normal morphological features and variances are discussed. Important and common types of implant related complications as well as pitfalls are also reviewed. When available, counterpart mammograms or MRI images will be shown for correlation and comparison.

Results: Commonly encountered complications in our practice include capsular retraction, intra-capsular rupture and extra-capsular rupture. Conversely, normal morphological appearances are also commonly observed and should not be mistaken for pathological changes. These appearances include radial folds, reverberation artifacts, peri-implant seroma, implant valve capsular calcifications and other appearances.

Conclusion: Ultrasound can reliably identify the appearances of normal and abnormal breast implants. Knowledge and recognition of these features will enable the accurate assessment of implant integrity and consequential delivery of appropriate patient care.