Sonography in capsular contracture after breast augmentation: value of established criteria, new techniques and directions for research

Abstract

Capsular contracture or capsular fibrosis is the most common complication following breast augmentation with implants. Sonography is usually the initial imaging test performed to examine a suspicious implant. In contrast to the large number of patients developing capsular fibrosis there is only sparse literature reporting about sonographic findings. In this letter after a brief review of normal sonographic findings after breast augmentation, established ultrasound findings suggestive of capsular fibrosis (deformity, increased number of radial folds and thickening of the fibrous capsule) are discussed. The possible value of new techniques and possible directions for further research are addressed.

Keywords: Breast augmentation; Capsular contracture; Sonography.

Fig. 1

Sonographic findings of a normal implant shell showing the typical two-layer appearance and an implant valve

Fig. 2

Sonographic findings of a normal implant showing a radial fold, minimal periprosthetic fluid and the fibrous capsule

Fig. 3

Increased number of radial folds creating an undulated implant surface in a patient with clinical findings of capsular contracture. Note also the prominent and irregular fibrous capsule

Fig. 4

Thickened fibrous capsule in a patient with capsular contracture