Imaging of Becker Implants – A Pictorial Presentation
Here is a visual series of how the Becker Implants look through x-ray in different scenarios.
i C.Glynn, J. Litherland
Double lumen breast implants are increasingly used in breast reconstruction procedures and it is important that radiologists be aware of their appearance on various imaging modalities. We present a pictorial series demonstrating typical appearances on radiography, ultrasound, CT & MRI.
Mentor Becker (Mentor Corporation, Santa Barbara, California, USA) double lumen implants consist of an outer (fixed volume) silicone compartment and a saline-filled inner lumen. There is a laterally-placed port or valve to allow expansion of the saline component as needed. These are the most commonly used double lumen implants seen in our department. (Fig.1&2).
As the saline compartment functions as an expander and is frequently underfilled, there are often multiple infoldings of the inner capsule which should not be mistaken for implant rupture on cross sectional imaging.(Fig.3 &4).
It is important to be clear about the type of implant under investigation when performing ultrasound examination also; the second chamber can be easily visualised and should not be misinterpreted either as the stepladder sign or a post rupture collection of a single lumen silicon implant. (Fig.5).
At the time of surgery, the tubing is often held in a posterolateral position subcutaneously by a skin stitch. Once the implant has been inflated to a satisfactory cosmetic appearance, the tubing can be detached from the posterior aspect of the implant. Occasionally, the port can be displaced &, in the ultrasound image below, it is seen to lie anterior to the implant. (Fig.6).
MRI is commonly used for assessment of implant integrity, as it demonstrates the lumen clearly, along with the tubing. The use of T1 and T2 MRI sequences allows easy differentiation of the saline and silicone lumina. (Fig.7).
In summary, familiarity with the normal appearance of double lumen breast implants across several modalities should prevent a misinterpretation of implant rupture.
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Plastic Surgery - Dr. Hilton Becker, MD - 670 Glades Road, Suite 220, Boca Raton, Florida 33431