M R imaging is more accurate than mammography or sonography for detecting implant rupture F 1-4]. MR imaging is also useful for evaluating capsular contracture and herniation of the implant through the fibrous capsule and for detecting silicone within lymph nodes and breast tissue. This essay shows the wide variation of MR imaging findings in normal and complicated implants in a large series imaged with a consistent technique. We examined with MR imaging 185 women with 345 breast implants (226 silicone. 52 double-lumen. and 67 saline). One hundred sixty-one patients had bilateral implants, nine patients had unilateral implants. and three patients had more than two implants. Twelve patients had fl() implants at the time of our study. but had had silicone implants in the past. The number of patients reporting local symptoms including breast pain and burning or altered breast size or shape was I 26. Nineteen patients also reported systemic symptoms including arthralgia. paresthesia. or fatigue. Eight patients either had rheumatologic symptoms or carried rheumatologic diagnoses. Forty of the patients were asymptomatic. Seventythree implants were removed from 36 patients in the surgical subpopulation of this series. All scans were obtained on a I .5-T scanner (Siemens Medical Systems. Iselin. NJ) using a dedicated dual-breast surface coil and commercially available imaging sequences including fat-suppressed fast inversion recovery dual-echo sequences (turbo short inversion time inversion recovery IturboSTIRl) in the axial. coronal. and sagittal planes with these parameters: TR range/first-echo TE and seeond-echo TE. 4()OO-5000/19 and 93: inversion time. 1(X) msec: thickness. 5 mm: excitations. one: matrix size, 192 x 256. A T2-weighted gradient-echo sequence (threedimensional precession steady-state imaging fast sequence) was filmed in the coronal plane with these parameters: 17/7: flip angle. 70#{176}: slab. I 30 mm: excitations. one: matrix size. 128 x 256. Silicone-suppressed turhoSTIR sequences were obtained in the coronal and axial planes with these parameters: 4(X)0-500()/l9: inversion time. 400 msec: thickness. 7 mm: excitations, one: matrix size. 192 x 256. Total imaging time was approximately 45 mm. Patients were scanned in the prone position. All patients with MR imaging evidence of rupture were referred for explantation. Correlation was made with surgical findings and pathologic evaluation of the implants. Normal Implant Appearances