American Society of Plastic Surgeons
For Medical Professionals
 
Bmiles34
one year ago
Answered

Extrusion

Once an implant has become exposed due to the skin being too thin to support it or the implant being too big to be supported, how is that treated? Do you just exchange the implant out with a new one or how does that work?

Procedure: Breast Implant Revision
Type: Question

Replies 4

Rahul Vemula
ASPS Surgeon
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Thanks for your question. Once an implant becomes exposed it must be removed. If you have had radiation, you are at greater risk for implant exposure and extrusion. If my radiated patients with an extruded implant, I do not put anything in back as the same time. I would wait a minimum of 3 months prior to restarting reconstruction.

Best wishes!

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Dimitrios Karypidis
ASPS Int. Surgeon

An externalized implant is by definition a contaminated one and has to be removed. Now an implant should never be supported by 'just skin' and on that premise, an exposed implant imply breast tissues that have failed either locally ( inflammation, vascularization, mechanical disruption etc) or on the entire breast. The entire breast should be treated and no local repairs are likely to help. Usually after removing the implant and waiting for 3-4 months for breast tissue to recover, breast reconstruction follows with several options including a) a mastopexy (breast lift) procedure with or without new implant, b) a breast reduction procedure if there is tissue excess, c) new implant with or without the use of acellular dermal matrix or the newer poly-4-hydroxybutyrate mess for additional support, d) muscle transfer with or without implant etc. The decision depends on many parameters such as the age, expectations, etiology implant failure, breast tissue quality etc

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Nelson Castillo

Thank you for sharing your excellent question. Typically exposure of a breast implant will require removal. Depending on the reason for the extrusion care of the natural breast tissue and skin must be performed first and the decision for either a smaller implant, or an alternative reconstruction, must be done. Hope this helps.

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Susan Buenaventura
ASPS Surgeon
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Once the implant has extruded through the skin, it must be removed, the breast allowed to heal ( or the site might be excised and closed that day, and after 2-3 months you can safely replace the implant. Otherwise the infection risk is too great.

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