Updated September 2018
There are several potential complications associated with breast augmentation surgery, and breast implant extrusion is one. While very rare—occurring in less than 2 percent of patients—it’s important to be aware of this and all possible risks involved with getting breast implants.
What is breast implant extrusion?
Breast implant extrusion, or breast implant exposure, occurs when the breast skin and tissues holding the implant fail, causing the implant to protrude through the skin and become exposed. Happening in less than 2 percent of patients, this complication can occur shortly after breast augmentation or down the road. When breast implant extrusion does take place, the implant is typically exposed at the inframammary fold, where the incision was made for breast augmentation, breast reconstruction, or breast lift.
What causes breast implant extrusion?
Breast implant extrusion can occur for a variety of reasons, the chief among them being improper wound healing due to an infection, trauma, too little soft tissue coverage, an oversized implant coupled with too little tissue coverage, or lack of blood supply.
Other factors can lead to weakness of the incision, resulting in breast implant extrusion. They include:
- Injections into scar site
- Radiation therapy
- Strenuous activity too soon after breast augmentation, breast lift, or breast reconstruction
Breast implant extrusion signs
With breast implant extrusion, patients often start off feeling a pointy edge of their implant and it remains in the same spot. Or, they may notice that the breast skin has become very thin and translucent. This is known as threatened exposure. If treatment is not sought in at least this stage, actual exposure can occur, where the implant breaks through the skin and is partially exposed on the outside of the body.
How is breast implant extrusion treated?
Breast implant extrusion calls for surgery and removal of the implant. The surgeon will then enact any combination of these methods:
- Administering antibiotics
- Implant exchange
- Pocket relocation or repositioning
- Wound debridement and closure
- Tissue or muscular flap coverage
If implant replacement is possible, a new implant must be reinserted to prevent further complications like capsular contracture and implant distortion. Whether a new implant is placed or the implants are removed indefinitely depends on how severe the exposure is (threatened vs actual) as well as the cause of exposure.
The rate of successful reimplantation is greater when a patient is in the threatened exposure stage and either infection or necrotic tissue is absent or very limited. Severe infection and necrosis can destroy breast tissue, making the breasts unable to hold implants without extrusion, bottoming out, or other complications occurring.
How can breast implant extrusion be prevented?
Preventing breast implant extrusion consists of:
- Avoiding strenuous activity until your surgeon advises you can do so
- Choosing an implant that is an appropriate size
- Selecting a plastic surgeon who is careful not to over-dissect your breast pockets and who uses proper, strong closure techniques
- Avoiding infection or treating infection immediately
- Talking to your surgeon about any underlying conditions that could affect healing
- Considering incision sites other than inframammary fold and placement type like over the muscle if your skin and breast tissue are thin
Want to know more about breast implant extrusion?
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Spear SL, Howard MA, Boehmler JH, Ducic I, Low M, Abbruzzese MR. The infected or exposed breast implant: Management and treatment strategies. Plast Reconstr Surg. 2004;113:1634–1644.
Gatti GL, Lazzeri D, Stabile M, Romeo G, Massei A. Salvage of an Infected and Exposed Breast Device with Implant Retention and Delayed Exchange. Plastic and Reconstructive Surgery: January 2010 - Volume 125 - Issue 1 - p 19e-20e doi: 10.1097/PRS.0b013e3181c2a312
Gargano F, Ciminello F, Podda S, De Santis G. Salvage of Exposed Breast Implant Using Capsular Flaps. Eplasty. 2009; 9: e41