Figure 4.

A 76-year-old female with bilateral mastectomy with implant reconstruction who presented with clinical asymmetry. (a, b) DECT silicone series show radial folds and focal silicone outside the silicone envelope but contained within the fibrous capsule, consistent with gel bleed (arrows). No extracapsular silicone is present. (c, d) Sagittal and coronal CT reformats show radial folds and keyhole appearance of gel bleed (arrows). Surgical findings were consistent with gel bleed without implant rupture. DECT, dual energy CT.