Highlight
Silicone axillary lymphadenopathy (SAL) is frequently encountered in patients with ruptured fourth-generation cohesive silicone breast implants. This retrospective study involving 260 patients correlates imaging findings from MRI and ultrasound with surgical confirmations, establishing that SAL is more commonly associated with extracapsular ruptures and significantly linked to increased implant age at explantation. The study underscores the importance of incorporating implant age and rupture type into patient counseling and surgical planning.