Rupture and Intrapleural Migration of a Cohesive Silicone Gel Implant after Augmentation Mammoplasty: A Case Report.

Lee, Jun Yong; Kim, Han Koo; Kim, Woo Seob; Park, Bo Young; Bae, Tae Hui; Choe, Ju Won

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Case Report

Journal of the Korean Society of Plastic and Reconstructive Surgeons 2011;38(3):323-325.
Published online May 1, 2011.

Rupture and Intrapleural Migration of a Cohesive Silicone Gel Implant after Augmentation Mammoplasty: A Case Report.

Jun Yong Lee, Han Koo Kim, Woo Seob Kim, Bo Young Park, Tae Hui Bae, Ju Won Choe

¹Department of Plastic and Reconstructive Surgery, Chung Ang University Hospital, Seoul, Korea. psbth@cau.ac.kr
²Department of Thoracic Surgery, Chung Ang University Hospital, Seoul, Korea.

Abstract

PURPOSE
Breast implant ruptures and displacement are problematic complications after augmentation mammoplasty. The authors report a patient whose cohesive silicone gel implant ruptured and migrated into the pleural cavity after augmentation mammoplasty. METHODS: A 23-year-old female had received augmentation mammoplasty at a local clinic a week before visiting our hospital. When the patient's doctor performed a breast massage on the sixth postoperative day, the left breast became flattened. The doctor suspected a breast implant rupture and performed revision surgery. The implant, however, was not found in the submuscular pocket and no definite chest wall defect was found in the operative field. The doctor suspected implant migration into the pleural cavity, and after inserting a new breast implant, the doctor referred the patient to our hospital for further evaluation. The patient's vital signs were stable and she showed no specific symptoms except mild, intermittent pain in the left chest. A CT scan revealed the ruptured implant in the left pleural cavity and passive atelectasis.
RESULTS
The intrapleurally migrated ruptured implant was removed by video-assisted thoracic surgery(VATS). There were no adhesions but there was mild inflammation of the pleura. No definite laceration of the pleura was found. The patient was discharged on the first day after the operation without any complications.
CONCLUSION
Surgeons should be aware that breast implants can rupture anytime and the injury to the chest wall, which may displace the breast implant into the pleural cavity, can happen during submuscular pocket dissection and implant insertion.

Keywords: Breast implant; Mammoplasty; Pleural cavity

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