A clinical case of secondary breast augmentation after previous implants removal

Authors

DOI:

https://doi.org/10.30978/GS-2024-2-67

Keywords:

mammoplasty, breast augmentation, implant replacement

Abstract

The patient underwent primary breast augmentation at a different clinic. Two years later, the implants were replaced with larger breast implants (500 ml each). Three months after the procedure, inflammation of the right and left mammary glands occurred, which led to the removal of both implants. The patient was 24 years old when the surgery took place. She underwent a preoperative examination in accordance with the standards set by the Ministry of Health of Ukraine. The patient came to us for breast augmentation, correction of mammary gland contour imperfections, and management of postoperative scars. Round‑shaped and moderate‑profile implants were selected. Implant parameters: width 13 cm, projection 4.4 cm, implant texture — microtexture, volume 400 ml. We placed the implants in the retropectoral space, and used the dual‑plane method for cavity formation. The surgical procedure lasted for a total of 140 minutes. The duration of the patient’s hospitalisation was one day. No drains were used. The scars on the abdomen were also corrected and fixed in the projection of the inframammary fold. No complications occurred in the postoperative period. The patient received antibiotic therapy and took nonsteroidal anti‑inflammatory drugs. Postoperative wound management was carried out. We prescribed compression underwear for the patient to wear for two months after surgery.

Mammoplasty is a commonly performed procedure in plastic surgery. It aims to produce predictable and agreed‑upon aesthetic outcomes for the patient while maintaining a low rate of complications by adhering to modern surgical standards. The patient experienced complications that led to a significant scarring process. The pectoralis major muscle had a significant deformity, and the tissue showed scarring. The lack of muscle elasticity complicated the implant placement, leading to specific challenges throughout the operation. The occurence of complications following mammoplasty invariably has a lasting impact on the capsule’s formation and increases the risk of developing both early and late postoperative issues.

 

Author Biographies

O.  Panchuk, Medical Centre Likomed Clinic, Kyiv; Bogomolets National Medical University, Kyiv

PhD, MD

I.  Donets, Medical Centre Likomed Clinic

MD

K.  Galperin, Bogomolets National Medical University, Kyiv

Senior Assistant, Department of Surgery with a Course of Emergency and Vascular Surgery

References

Adams WP Jr, Calobrace MB. Discussion: The Questionable Role of Antibiotic Irrigation in Breast Augmentation. Plast Reconstr Surg. 2019 Jul;144(1):253-257. http://doi.org/10.1097/PRS.0000000000005727. Erratum in: Plast Reconstr Surg. 2020 Nov;146(5):1212. http://doi.org/10.1097/PRS.0000000000007513. PMID: 31246842.

Adams WP Jr, Culbertson EJ, Deva AK, R Magnusson M, Layt C, Jewell ML, Mallucci P, Hedén P. Macrotextured Breast Implants with Defined Steps to Minimize Bacterial Contamination around the Device: Experience in 42,000 Implants. Plast Reconstr Surg. 2017 Sep;140(3):427-431. http://doi.org/10.1097/PRS.0000000000003575. PMID: 28841597.

Adams WP Jr, Rios JL, Smith SJ. Enhancing patient outcomes in aesthetic and reconstructive breast surgery using triple antibiotic breast irrigation: six-year prospective clinical study. Plast Reconstr Surg. 2006 Jan;117(1):30-6. PMID: 16404244.

Bachour Y, Bargon CA, de Blok CJM, Ket JCF, Ritt MJPF, Niessen FB. Risk factors for developing capsular contracture in women after breast implant surgery: A systematic review of the literature. J Plast Reconstr Aesthet Surg. 2018 Sep;71(9):e29-e48. http://doi.org/10.1016/j.bjps.2018.05.022. Epub 2018 Jun 9. PMID: 29980456.

Capriotti K, Capriotti JA. Topical iodophor preparations: chemistry, microbiology, and clinical utility. Dermatol Online J. 2012 Nov 15;18(11):1. PMID: 23217942.

Carvajal J, Carvajal M, Hernández G. Back to Basics: Could the Preoperative Skin Antiseptic Agent Help Prevent Biofilm-Related Capsular Contracture? Aesthet Surg J. 2019 Jul 12;39(8):848-859. http://doi.org/10.1093/asj/sjy216. PMID: 30137191.

Chopra K, Gowda AU, McNichols CHL, Brown EN, Slezak S, Rasko Y. Antimicrobial Prophylaxis Practice Patterns in Breast Augmentation: A National Survey of Current Practice. Ann Plast Surg. 2017 Jun;78(6):629-632. http://doi.org/10.1097/SAP.0000000000000942. PMID: 27922894.

Clarke-Pearson EM, Lin AM, Hertl C, Austen WG, Colwell AS. Revisions in Implant-Based Breast Reconstruction: How Does Direct-to-Implant Measure Up? Plast Reconstr Surg. 2016 Jun;137(6):1690-1699. http://doi.org/10.1097/PRS.0000000000002173. PMID: 27219225.

Federica G, Tommaso F, Alessia C, Agostino C, Florian B, Antonio G, Domenico Nicola M, Abdallah R, Carmela S, Lorenzo S, Sergio B. Use of Antimicrobial Irrigation and Incidence of Capsular Contracture in Breast Augmentation and Immediate Implant-Based Breast Reconstruction. Aesthetic Plast Surg. 2023 Dec;47(6):2345-2350. http://doi.org/10.1007/s00266-023-03453-5. Epub 2023 Jul 6. PMID: 37410129; PMCID: PMC10784374.

Flugstad NA, Pozner JN, Baxter RA, Creasman C, Egrari S, Martin S, Messa CA 3rd, Oliva A, Schlesinger SL, Kortesis BG. Does Implant Insertion with a Funnel Decrease Capsular Contracture? A Preliminary Report. Aesthet Surg J. 2016 May;36(5):550-6. http://doi.org/10.1093/asj/sjv237. Epub 2015 Dec 15. PMID: 26672104.

Handel N, Cordray T, Gutierrez J, Jensen JA. A long-term study of outcomes, complications, and patient satisfaction with breast implants. Plast Reconstr Surg. 2006 Mar;117(3):757-67; discussion 768-72. http://doi.org/10.1097/01.prs.0000201457.00772.1d. PMID: 16525261.

Hedén P, Montemurro P, Adams WP Jr, Germann G, Scheflan M, Maxwell GP. Anatomical and Round Breast Implants: How to Select and Indications for Use. Plast Reconstr Surg. 2015 Aug;136(2):263-272. http://doi.org/10.1097/PRS.0000000000001474. PMID: 26218376.

Hemani ML, Lepor H. Skin preparation for the prevention of surgical site infection: which agent is best? Rev Urol. 2009 Fall;11(4):190-5. PMID: 20111631; PMCID: PMC2809986.

Hidalgo DA, Sinno S. Current Trends and Controversies in Breast Augmentation. Plast Reconstr Surg. 2016 Apr;137(4):1142-1150. http://doi.org/10.1097/01.prs.0000481110.31939.e4. PMID: 27018669.

Hu H, Johani K, Almatroudi A, Vickery K, Van Natta B, Kadin ME, Brody G, Clemens M, Cheah CY, Lade S, Joshi PA, Prince HM, Deva AK. Bacterial Biofilm Infection Detected in Breast Implant-Associated Anaplastic Large-Cell Lymphoma. Plast Reconstr Surg. 2016 Jun;137(6):1659-1669. http://doi.org/10.1097/PRS.0000000000002010. PMID: 26890506.

Jewell ML, Adams WP Jr. Betadine and Breast Implants. Aesthet Surg J. 2018 May 15;38(6):623-626. http://doi.org/10.1093/asj/sjy044. PMID: 29452341.

Keane GC, Keane AM, Diederich R, Kennard K, Duncavage EJ, Myckatyn TM. The evaluation of the delayed swollen breast in patients with a history of breast implants. Front Oncol. 2023 Jul 5;13:1174173. http://doi.org/10.3389/fonc.2023.1174173. PMID: 37476374; PMCID: PMC10354431.

Khan UD. Breast augmentation, antibiotic prophylaxis, and infection: comparative analysis of 1,628 primary augmentation mammoplasties assessing the role and efficacy of antibiotics prophylaxis duration. Aesthetic Plast Surg. 2010 Feb;34(1):42-7. http://doi.org/10.1007/s00266-009-9427-8. Epub 2009 Oct 20. PMID: 19841968.

Lee HK, Jin US, Lee YH. Subpectoral and precapsular implant repositioning technique: correction of capsular contracture and implant malposition. Aesthetic Plast Surg. 2011 Dec;35(6):1126-32. http://doi.org/10.1007/s00266-011-9714-z. Epub 2011 Apr 22. PMID: 21512869; PMCID: PMC3236291.

Lista F, Austin RE, Saheb-Al-Zamani M, Ahmad J. Does Implant Surface Texture Affect the Risk of Capsular Contracture in Subglandular Breast Augmentation and Breast Augmentation-Mastopexy? Aesthet Surg J. 2020 Apr 14;40(5):499-512. http://doi.org/10.1093/asj/sjz241. PMID: 31529039.

Olinger TA, Berlin NL, Qi J, Hamill JB, Kim HM, Pusic AL, Wilkins EG, Momoh AO. Outcomes of Immediate Implant-Based Mastectomy Reconstruction in Women with Previous Breast Radiotherapy. Plast Reconstr Surg. 2020 Jun;145(6):1029e-1036e. http://doi.org/10.1097/PRS.0000000000006811. PMID: 32195865.

Palubicka A, Jaworski R, Wekwejt M, Swieczko-Zurek B, Pikula M, Jaskiewicz J, Zielinski J. Surgical Site Infection after Breast Surgery: A Retrospective Analysis of 5-Year Postoperative Data from a Single Center in Poland. Medicina (Kaunas). 2019 Aug 21;55(9):512. http://doi.org/10.3390/medicina55090512. PMID: 31438594; PMCID: PMC6780406.

Pittet B, Montandon D, Pittet D. Infection in breast implants. Lancet Infect Dis. 2005 Feb;5(2):94-106. doi: 10.1016/S1473-3099(05)01281-8. PMID: 15680779. https://pubmed.ncbi.nlm.nih.gov/15680779/

Prantl L, Momeni A, Brebant V, Kuehlmann B, Heine N, Biermann N, Brix E. Recommendations for the Use of Antibiotics in Primary and Secondary Esthetic Breast Surgery. Plast Reconstr Surg Glob Open. 2020 Jan 24;8(1):e2590. http://doi.org/10.1097/GOX.0000000000002590. PMID: 32095400; PMCID: PMC7015596.

Sarwer DB, Nordmann JE, Herbert JD. Cosmetic breast augmentation surgery: a critical overview. J Womens Health Gend Based Med. 2000 Oct;9(8):843-56. http://doi.org/10.1089/152460900750020874. PMID: 11074950.

Stevens WG, Calobrace MB, Harrington J, Alizadeh K, Zeidler KR, d’Incelli RC. Nine-Year Core Study Data for Sientra’s FDA-Approved Round and Shaped Implants with High-Strength Cohesive Silicone Gel. Aesthet Surg J. 2016 Apr;36(4):404-16. http://doi.org/10.1093/asj/sjw015. PMID: 26961987.

Venkataram A, Lahar N, Adams WP. Enhancing Patient Outcomes in Aesthetic Breast Implant Procedures Using Proven Antimicrobial Breast Pocket Irrigations: A 20-Year Follow-up. Aesthet Surg J. 2023 Jan 9;43(1):66-73. http://doi.org/10.1093/asj/sjac238. PMID: 36039664.

Wiener TC. The role of betadine irrigation in breast augmentation. Plast Reconstr Surg. 2007 Jan;119(1):12-15. discussion 16. http://doi.org/10.1097/01.prs.0000251088.51675.a8. PMID: 17255650.

Wixtrom RN, Stutman RL, Burke RM, Mahoney AK, Codner MA. Risk of breast implant bacterial contamination from endogenous breast flora, prevention with nipple shields, and implications for biofilm formation. Aesthet Surg J. 2012 Nov;32(8):956-63. http://doi.org/10.1177/1090820X12456841. Epub 2012 Sep 10. PMID: 22964141..

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Published

2024-06-30

How to Cite

1.
Panchuk O, Donets I, Galperin K. A clinical case of secondary breast augmentation after previous implants removal. ЗХ [Internet]. 2024Jun.30 [cited 2024Dec.27];(2):67-74. Available from: http://generalsurgery.com.ua/article/view/308113

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Clinical Case