Figure 15.

Ultrasound appearance of extracapsular rupture. (a) Free silicone in the breast along the upper outer part of the implant, indicating extracapsular rupture. Typical appearance of a marked hyperechoic area with posterior shadowing, referred to as “snowstorm appearance”. (b) “Snowstorm” appearance of an axillary lymph node in another patient. This was an isolated finding, and no rupture was documented on MRI. This was related to silicone gel bleed, i.e., microscopic diffusion of silicone molecules through the semipermeable weakened but intact implant elastomer shell.