CTICasesUpside-down fluid level on CT from silicone breast implant rupture
Imaging findings
CT chest of a patient with a ruptured silicone breast implant shows an intracapsular rupture with a clear fluid-fluid level where the hyperattenuating (denser-appearing) silicone layer sits on top of the dependent, water-equivalent fluid layer.
Key takeaways
Because the atomic number of silicon (Z=14) is higher than that of carbon and oxygen, silicone attenuates X-rays more than water, making it appear hyperdense (white) on CT. However, its physical density is lower than water, creating a paradoxical 'upside-down' fluid level where the brighter silicone layer floats on top.
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