Dr. Vu explains that complications such as infection, abscess formation, prolonged wound healing, and excessive fluid accumulation can require extended courses of high-dose antibiotics. While this may alleviate symptoms like pain and inflammation, inadequate management can lead to persistent subclinical infections. Over time, this allows contaminated fluids, coagulated blood, and adhesive pseudomembranes to accumulate, making reimplantation infeasible.
Breast implant removal surgery is not a simple procedure. Photo courtesy of Dung Ho |
Addressing complications
In cases of severe contamination, a secondary surgical procedure may be necessary. This involves debriding the implant pocket, collecting samples for antibiotic sensitivity testing, inserting drainage systems for monitoring, and irrigating the cavity to stabilize and remove contamination.
Other complications, such as capsular contracture, ruptured implants, or abnormalities in the implant pocket caused by textured or smooth implants, require specific surgical techniques for safe removal.
In some cases, residual gel, excessive tissue excision, or improper pocket adherence after implant removal can lead to inflammation, making it difficult to place implants in future procedures. Left untreated, such inflammation can prolong wound healing and delay recovery.
If internal inflammation is not thoroughly treated, it can lead to delayed or incomplete wound healing. For open wounds, improper care can lead to cross-contamination from external sources, delaying or preventing recovery. Prolonged inflammation not only hinders wound healing but also negatively affects the patient’s overall health and immune system.
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Procedure for breast implant removal with laryngeal mask anesthesia. Photo courtesy of Dung Ho |
Advances in anesthesia and surgical techniques
Laryngeal mask anesthesia is increasingly preferred for breast implant removal surgeries.
This method reduces airway irritation and minimizes the risk of laryngeal trauma, offering patients a more comfortable recovery with fewer side effects compared to traditional endotracheal intubation.
Ultrasonic scalpels are also used during these procedures to ensure minimal tissue damage, a bloodless operation, and non-traumatic removal of the implant pocket.
Post-operatively, patients experience minimal pain, can often be discharged within six hours, and require no additional painkillers or antibiotics.
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Case of managing an inflammatory cavity: debridement, removal of recesses, and irrigation of a soft tissue abscess. Photo courtesy of Dung Ho |
Case studies in managing complications
A patient, T.T., 35, experienced complications after multiple implant surgeries. Her initial implant in April 2022 led to an abscess and removal. A second implant in December 2023 resulted in fluid accumulation, requiring removal and drainage.
In December 2024, after a chest ultrasound and negative infection test results T. sought reimplantation. During surgery, Dr. Vu discovered pseudomembranes and yellow secretions in the implant pocket, indicating poor cavity hygiene and inflammation.
Additionally, the entire left pectoralis major muscle below ribs 4, 5, and 6 remained intact and uncut. The doctor contacted the patient’s family to agree on the approach, which involved removing all recesses and partially excising the pocket in the lower areas of both the right and left sides. The cavity was then irrigated with hydrogen peroxide and Betadine, followed by thorough rinsing with saline. Postoperative irrigation drains were placed, and pseudomembranes were collected for antibiotic sensitivity testing, histopathological analysis, and tuberculosis bacterial examination.
Another patient underwent breast augmentation and areolar reduction in November 2024 but developed symptoms of pain, swelling, and Ten days after returning to the aesthetic center for suture removal, she developed a fever, a bitter taste in her mouth, and chills and was prescribed intravenous antibiotics, oral antipyretics, and anti-inflammatory medication.
Three days later, during a follow-up examination, the doctor observed abnormalities, including yellow fluid draining from the cavity. The decision was made to remove the breast implants, leave the wound open without drainage placement, and continue the prescribed oral medications.
Upon consultation with Vu and clinical examination, the doctor observed pale red fluid draining from the cavity through the open incision, which was in direct communication with the implant pocket. Dr. Vu ordered tests to assess the infection and develop an appropriate treatment plan, followed by continuous wound irrigation for seven days at the center.
Due to her weakened immune system following multiple surgeries, a non-surgical approach was adopted to support her recovery and overall health.
Breast implant removal requires meticulous planning and post-operative care to address complications and reduce the risk of long-term issues. According to Vu, effective management includes maintaining proper wound hygiene, addressing inflammation, and monitoring for signs of infection to ensure optimal outcomes for patients.
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