Cosmetic Breast Surgery: Ultrasound Evaluation

Background: Several types of cosmetic breast surgery including breast augmentation, reduction and reconstruction are commonly practiced nowadays. Mammograms after breast conservation therapy for carcinoma of after cosmetic surgery require correlation with physical findings and surgical procedures performed. Mammographic appearances or post surgical changes after these procedures are commonly encountered. Ultrasonography is a useful complement to mammography in evaluation of post-operative changes.Aim of the Study: Was to evaluate the role of the grayscale ultrasound in the postoperative follow-up and detection of complication after various types of cosmetic breast surgery.Subjects and Methods: Twenty six female patients were included in the study, (age range 14-52 years). Standard mammographic views (cranio-caudal and mediolateral oblique were taken in 24 cases, in the other two cases (early post operative) mammography was painful. Ultrasound evaluation was undergone in all cases. MRI was done in 2 cases.Results: In 6 cases with breast augmentation, 3 cases were normal, the other three showed extracapsular rupture in 4 implantes, internal wall derangement in two, breaks and internal echoes inside in one implant, in this case MRI axial and sagittal spin echoes was done, it confirmed the intra and extracapsular rupture. Regarding the reduction mammoplasty (11 cases): Us replaced mammography in early postoperative cases (2 cases) with tender inflamed breasts, in three cases mass discrimination fibroadenomas, cysts and fat necrosis was accurately assessed. In Reconstructed breast (9 cases): Us was complementary to mammography in assessment of ill defined dense area. Us guided fine needle biopsy was done in 2 cases of fat necrosis.Conclusion: Ultrasound examination is highly sensitive and specific in post-operative assessment of saline implants integrity in augmentation mammplasty. Ultrasonography is a useful complement to mammography in demonstrating the origin of a palpable mass after other types of surgery, US guided fine needle biopsy is minimally invasive technique in confirming the diagnosis of suspicious mass.