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Breast Implant Complications Flashcards

(50 cards)

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1
Q

What is the most common complication of breast implantation?

A

Capsular contracture

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2
Q

Capsular contracture

A

Scar tissue forms around the implant and squeezes the implant causing varying degrees of firmness, discomfort and implant deformation

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3
Q

What do normal implant demonstrates?

A

Compressibility during real time scanning

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4
Q

What are 3 sings of a capsular contracture?

A
  1. Hard
  2. Non-compressible
  3. Rounded or balloon shape implant
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5
Q

How many grades are there for capsular contracture?

A

4

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6
Q

What is grade 1 for capsular contracture?

A

None
- the augmented breast feels as soft as an unoperated breast

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7
Q

What is grade 2 for capsular contracture?

A

Minimal
- the breast is less soft; the implant can be palpated but is not visible

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8
Q

What is grade 3 for capsular contracture?

A

Moderate
- the breast is firmer; the implant is felt easily and its presence is visible

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9
Q

What is grade 4 for capsular contracture?

A

Severe
- the implant is firm and often tender, painful, cool and distorted; its presence is obvious

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10
Q

What is a common complication of breast implantation?

A

Implant Rupture

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11
Q

Implant Rupture

A

The elastomer shell can weaken over and cause a leak

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12
Q

What is the lifespan of an implant?

A

~ 13 years

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13
Q

How can you diagnosis a saline implant rupture?

A

Clinically

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14
Q

How can you tell if a saline implant has ruptured?

A

Dramatic deflation of the implant

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15
Q

What happens after a saline implant ruptures?

A

IT gets reabsorbed by the body
- considered harmless

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16
Q

How can you tell if a silicone implant has ruptured?

A

Hard to detect because it leaks out very slowly
- clinically silent

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17
Q

Are are some symptoms that can be experience with a silicon implant rupture? (4)

A
  1. Size or shape of breast
  2. Breast pain or tenderness
  3. Numbness
  4. Burning or tingling sensation
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18
Q

What is the most common type of silicone implant rupture?

A

Intrascapular rupture

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19
Q

Intrascapular rupture

A

Break in the elastomer shell and silicone leaks out, but the silicone is still confined within the fibrous tissue capsule

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20
Q

How does an intrascapular rupture appear on US? (2)

A
  1. Ill-defined
  2. Poorly visualized implant margins
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21
Q

What kind of sign does intrascapular rupture have?

Study These Flashcards
A

Keyhole or noose sign

22
Q

Keyhole or noose sign

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A

If the apex of the radial fold becomes an area of weakening of the implant shell silicone may begin to collect with the fold, causing it to expand and produce a keyhole or noose appearance

23
Q

What is the easiest sign for intrascapular rupture?

Study These Flashcards
A

Keyhole or noose sign

24
Q

Subscapular line sign

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A

Silicone may escape through weak areas within the shell and expand the space between the fibrous capsule and the elastomer shell disrupting the normal trilaminar line appearance of the capsule shell complex

25
What is another name for a Stepladder sign?
Parallel line sign
26
Stepladder sign
Silicone escapes the implant shell, the shell progressively folds inward on itself and produces a series of thin, parallel echogenic lines
27
What is the most reliable finding to suggest intrascapular rupture?
Stepladder sign
28
What is the stepladder sign on US for equivalent for on MRI?
Linguine sign
29
Extracapsular rupture
Occurs when there is a break in both the elastomer shell of the implant as well as the fibrous capsule and silicone moves freely into the surrounding breast tissue
30
How do extrascapular rupture appear on US? (2)
1. Snowstorm sign 2. Granulomas
31
What is another term for a snowstorm sign?
Echogenic noise
32
What does a snowstorm look like on US?
Hyperechoic mass effect or intense, homogenous echoes with a loss of the poster wall
33
Where else can a snowstorm sign be seen?
Identified in affected axillary lymph nodes
34
What can the snowstorm sign be related to?
To the speed of sound moving slower in silicone compared to surrounding soft tissue
35
What are granulomas?
Silicone masses
36
How do granulomas appear on US? (3)
1. Hyperechoic noise pattern - similar to snowstorm sign 2. Hypoechoic or hyperechoic 3. Similar to other breast lesion (carcinoma) or nearly anechoic - similar to breast cysts
37
Is the speed of sound faster or slower than soft tissue?
Slower
38
What happens to structures with silicone?
Makes structures appear deeper
39
What is the most common type of silicone breast implant?
Single lumen, gel filled
40
What is the second most common type of silicone breast implant?
Double lumen implant with an inner silicone chamber surrounded by saline
41
What is the best modality to identify a rupture?
Non-contrast MRI - then US - then mammo
42
What modality do radial folds show up on? (2)
1. US 2. MRI - not mammo
43
What is non-contrast MRI used for?
Assess the integrity of implant
44
What is contrast MRI used for?
Asses for breast masses
45
Where do Pts that are undergoing breast augmentation surgery typically have their implants placed?
Subglandular prefectoral location
46
Where do Pts that are undergoing breast reconstruction surgery following a mastectomy typically have their implants placed? (2)
1. Subpectoral 2. Sub muscular location
47
What are 4 abnormalities for breast implants seen on mammo?
1. Calcification of the fibrous capsule surrounding the implant 2. Fibrous capsular contraction - essentially “strangling” the implant 3. Intracapsular rupture 4. Extracapsular rupture
48
Instracapsular rupture
Rupture of the implant with silicone remaining within the fibrous capsule formed by the body
49
Extracapsular rupture
Free silicone within the breast, outside the implant and fibrous capsule
50

Breast (43 decks)

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