Complications of Implant Reconstruction

The complications associated with breast implant reconstruction are listed in Table 14-1. Of these, scar tissue is perhaps the most problematic for the reconstruction patient as time goes on. The body normally forms a layer of scar tissue around any artificial material implanted beneath the skin. With breast implants, that scar tissue is called a capsule and the process of scarring and subsequent deformation of the breast shape is called capsular contracture. If the capsule which forms remains thin and pliable, it will be nonvisible and nonpalpable and of little concern to a patient. In some patients the capsule can become quite thick, resulting in a firm breast which can be distorted in shape. The variability in capsule formation is a reflection of each individual's biologic response to an implant as well as responses to infection around the implant and surgical bleeding around the time of surgery. Capsular contracture requires surgery to relieve symptoms. That surgery consists of the removal of the scar tissue and replacement of the breast implant.

Figure 14-1 (Continued)

Despite the less extensive nature of breast reconstruction with implants, complications are common (Table 14-1) and tend to increase over time. It is for this reason that some patients choose to avoid implants and use other methods of reconstruction.

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