Factors affecting mammographic visualization of the breast after augmentation mammaplasty.

[OBJECTIVE] To measure the effect of various parameters on mammographic visualization of the breast after augmentation mammaplasty.

[DESIGN] Preoperative and postoperative mammography was performed in patients undergoing augmentation mammaplasty. The area of breast tissue visualized on each film was measured. Changes in the area visualized were correlated with a variety of different parameters.

[SETTING] The Breast Center, Van Nuys, Calif, a free-standing multidisciplinary breast diagnostic and treatment facility.

[PATIENTS] The 68 women (126 breasts) represent a consecutive sample of patients undergoing augmentation mammaplasty for whom preoperative and postoperative mammograms were available.

[MAIN OUTCOME MEASURES] Area visualized was correlated with degree of capsular contracture, implant position, type of mammography, preoperative breast size, implant size, and implant type.

[RESULTS] The major factor affecting mammography is capsular contracture. Little or no capsular contracture results in a 30% reduction in the area visualized; moderate or severe contracture results in a 50% reduction. Other important factors include implant position (improved visualization with implant beneath pectoral muscle) and type of mammography performed (slightly more tissue seen with displacement technique). Very small preoperative breast size yields increased visualization. Implant size and type have little or no effect.

[CONCLUSIONS] In most women with breast implants, there is a decrease in measurable breast tissue on the postaugmentation mammogram. Capsular contracture and implant position exert a profound effect; type of mammography performed and preoperative breast size are also significant.