Objective To evaluate the diagnostic value of the spectral CT imaging on the complications after breast augmentations with silicone implants.Methods A lot of 22 cases with breast implants were scanned by the Gemstone spectral imaging (GSI) CT.The original data were loaded in processed workstation, analyzed by GSI analysis software, and then stored the series we needed.The features of the complications after breast augmentations with silicone implants were reviewed retrospectively on the spectral CT images.Results A lot of 44 breast implants scanned in our study and there were 23 breast implants with complications, including 7 breast implants with capsular rupture (6 breast implants with endometrial rupture detected by spectral CT, including 4 breast implants with endometrial rupture, 3 breast implants with outer membrane rupture and leakage), 13 breast implants with capsular contracture (classification according to Baker's classification, 6 in grade Ⅰand 7 in grade Ⅱ), 8 breast implants were moved and 2 breasts had foci of calcification.Conclusions The spectral CT imaging play important role in detecting the complications after breast augmentations with silicone implants by GSI analysis software.