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Magnetic resonance imaging of the breast in the diagnosis of silicone breast implant rupture is widely accepted to be the imaging study of choice for most women. Magnetic resonance imaging in the detection of silicone implant failure has been shown to have the highest sensitivity and specificity and has the ability to image the entire implant without the use of ionizing radiation. Unfortunately, some women are unable to have a magnetic resonance imaging examination of the breast because of contraindications such as cardiac pacemakers, aneurysm clips, and claustrophobia. Therefore, mammography, ultrasonography, and computed tomography will have roles in the diagnosis of silicone breast implant ruptures. This article illustrates the spectrum of imaging appearances of normal silicone gel implants and the appearances of silicone breast implant ruptures.