Preservation of Exposed Breast Implant for Immediate Breast Reconstruction

ABSTRACT

PURPOSE: Common complications of immediate breast reconstruction with implant are capsular contracture, malposition of implant, hematoma and seroma. Especially, the most severe complication is implant exposure caused by inflammation or necrosis of skin flap margin of mastectomy site. This article reports the experience of cases of salvage in such an exposure of implant. METHODS: From July, 2002 to Feb., 2009, sixty-five patients who underwent immediate breast reconstruction with implant were retrospectively analyzed. Exposure of implant was happened in 5 of 65 patients and they were treated at out patient district. Two of five patients were reconstructed with saline implnt and all of them underwent the enveloping of the implant with AlloDerm(R) and Serratus muscle flap. Remaning three patients were reconstructed with silicone implant and all of them underwent the enveloping of the implant with AlloDerm(R). RESULTS: In the group of patients who underwent reconstruction with saline implant, implant exposure was found in one patient due to partial necrosis of the margin of skin flap and debridement and primary repair were done. In the other one patient, dressing with antibiotic ointment were done. And debridement and primary repair were proceeded. In the group of patients who underwent reconstruction with silicone implant, implant exposure was found in one patient. After removal of the implant, tissue expansion was done and a new silicone implant was inserted. Implant exposure were found in the other two patients, antibiotics ointment application and primarily repaired. CONCLUSION: It was the common knowledge that the exposed implant should be removed. But salvage of the exposed implants may be possible with proper treatment. Four of five patients (80%) with exposed breast implant were salvaged with conservative management.