An open incision after breast augmentation can be secondary to placement of an implant that is too large relative to the soft tissue envelope. Improper closure of the surgical site may contribute to this. Also, external trauma to the area may result in this. This one of the reasons that plastic surgeons have protocols as far as exercise and activity restrictions that are very important to adhere to in order to minimize the chance of this happening. If the incision does open, one option may be to replace the implant after the pocket is washed out. However, if there is evidence of implant infection or the implant has been exposed for some time, then typically the implant will need to be removed. After 6 months or so once the infection has been treated, then the implant can be replaced.
Dr Ravi Somayazula
Surgical wound dehiscence is the expontaneous opening of a surgical wound. In the case of breast augmentation, if the wound dehiscence happens and the implant is exposed, most of the time the implant has to be removed.
Common causes of surgical breast augmentation surgical wound dehiscence are closure in tension (implants to big for the soft tissue envelope), blunt trauma to the breast ( eg. somebody fall on her chest) etc.
Recovery of a breast augmentation wound dehiscence varies depending if the implant can be kept in place or has to be removed.
If incision opens up or breast implant gets infected the implants need to be removed. If that happens there is waiting period before a new implant is placed. Length of waiting period depends on the cause of original problem.
Although rare, it is possible to get and infected implant. The most common cause is wound healing issues which then create a pathway for bacteria into the implant pocket. If an implant is exposed, it usually requires removal.
Yes, breast implant exposure is a potential complication associated with breast augmentation surgery. There may be several causes of incision line separation ("dehiscence"). Factors such as tension along the incision line, blood flow compromise, suture related problems, the presence of underlying fluid accumulation (pressure), infection (superficial or around the breast implant), postoperative trauma, history of nicotine use (goes back to blood flow compromise), poor nutrition, patient noncompliance and/or the paucity of soft tissue coverage are some examples. Patients who undergo more complicated procedures, such as breast augmentation/lifting surgery, certain types of revisionary breast surgery, and/or correction of constricted/tuberous breasts may be at greater risk ( in my experience), depending on the specific patient's situation/operation performed.
Personally, I think that the management of breast implant exposure situation needs to be individualized. In most cases, patients are best served by removing the breast implant involved, with the goal of breast re augmentation many months subsequently. Ultimately, timing of the re operation is best individualized depending on the clinical/microbiology findings.
Factors that I use when deciding when to return to the operating room include: the nature of the infection present initially ( superficial versus deep, microbiology results…), how well and/or quickly the patient's tissues "heal" after removal of breast implants, the patient's physical examination with emphasis on softness/pliability of the patient's tissues… Generally, if in doubt, best to undergo breast re augmentation later rather than too soon.
Keep in mind, what I have described is based on my personal experience/opinions. Your plastic surgeon, having the benefit of knowing your history and current situation, will always be your best resource.
Best wishes for an outcome that you will be pleased with longer-term.
One of the rare, but possible, complications from breast augmentation is for the incision to open leading to infection of the breast implant. This may often result in removal of the implant. If you have had a breast augmentation and think that your incision is open, you should call your surgeon and be seen by them as soon as possible.