Elective breast augmentation continues to be one of the most common surgical procedures performed by plastic surgeons, with an estimated 200,000 to 300,000 breast augmentations being performed annually in the U.S. What’s concerning is that outcome studies have demonstrated a significant rate of secondary surgery due to a variety of complications from breast augmentation, according to plastic surgeon Mitchell Brown, M.D., who was a panelist during the “Prevention and management of complications in breast augmentation” discussion at the American Society for Aesthetic Plastic Surgery’s The Aesthetic Meeting 2017 in San Diego, Calif.
“Most commonly, these indications for secondary surgery include capsular contracture, implant malposition, implant rupture or a request for size change,” says Dr. Brown, an associate professor of surgery at the University of Toronto, Toronto, Canada.
The two primary drivers of re-operation are capsular contracture and implant malposition, according to Dr. Brown.
“As with all surgery, prevention is the first key to management,” he says. “Adopting an approach that focuses on accurate patient assessment, tissue-based planning, precise surgical technique and attentive post-operative care will assist the surgeon in minimizing their own rates of complications.”
He cites published recommendations that have been shown to decrease incidence of both capsular contracture and malposition, which include use of perioperative antibiotics; minimal or no-touch technique; pocket irrigation to minimize bio-film; and atraumatic surgical dissection.
“A variety of best practice approaches have been championed over the last 10 to 15 years. This has certainly had a positive impact, bringing down the rate of revision and secondary surgery,” he says. “Ongoing education, including interactive live sessions that discuss strategies for patient selection, pre-operative planning, surgical technique and standardized post-operative care, are important in maintaining re-operation rates at as low a level as possible.”
Disclosure: Dr. Brown reports no relevant disclosures.