Pre-, intra-, and post-operative breast implant surgery problems might occur.
Poor planning (wrong surgical access, improper measurement) or surgical technique (over-dissection of the implant pocket, implant malpositioning, excessive bleeding) cause pre- and intra-operative problems.
Haematoma, seroma, infection, implant malposition, and discomfort occur early post-operatively. Late post-operative complications include infection, seroma, capsular contracture, poor muscular animations (excessive, unusual, painful) or distortions, implant visibility, implant malposition (descent, double bubble, waterfall deformity, etc.), implant rippling, wrinkling, and palpability, rupture, symmastia, poor scar healing, or scar hypertrophy.
Preventing breast augmentation problems how to avoid breast implant complication ?
Basic breast augmentation hygiene guidelines
All the evidence about the role of bacterial biofilm in implant-associated infection, capsular contracture, late seromas, and BIA-ALCL emphasizes the importance of accurate pre- and intra-operative strategies to reduce breast implant bacterial contamination and biofilm formation.
Our experience suggests many ways to reduce contamination and bacterial access during breast augmentation surgery, following Deva and colleagues' device-associated infection prevention measures (38).
Before surgery, patients should shower with antibacterial foam gel to reduce implant contamination.
At anesthetic induction, some surgeons provide antibacterial prophylaxis. Avoid peri-areolar incisions to avoid breast implant contamination by breast duct and tissue germs. Avoid parenchymal dissections and use subfascial, dual-plane methods. Atraumatic dissections with correct surgical equipment can reduce bleeding and tissue devascularization for accurate surgery. Adams and colleagues recommend implant pocket irrigation with triple antibiotic solution or 500 cc of saline solution with one amikacine vial per breast. We recommend fitting the implant pocket with saline solution-soaked gauzes for five minutes to remove dust, then cleaning the skin with antibacterial solution and removing the gauzes. When placing a breast implant, nipple shields (sterydrap) to avoid duct bacteria contamination, introduction sleeves, and changing surgical instruments, drapes, and gloves before opening the implant may be helpful. Minimize implant handling and pocket repositioning. Seat the patient and put the implant obliquely into the pocket without sizers.
We recommend closing the skin incision immediately after implant placement with three to five stitches between the muscle (inferiorly) and the Superficial Fascia System (SFS) superiorly, knotting them at the end to avoid implant damage. Then we recommend protecting the sutured skin with tape for as long as possible and using sterile ice around the breast to avoid even minor bleeding and seroma formation.
Suction, drainage, and implant external compression cause inflammation, thus a post-operative bra is plenty. The post-operative bra must be worn 24/7 for two months to prevent implant sliding, which reduces tissue adhesion and ingrowth and increases local inflammation.
Careful cosmetic breast augmentation surgery reduces complications.
Proactive haemostasis, electrocautery for sharp dissections, leaving the connective tissue on the ribs, tailored pocket dissection, topic antibiotic irrigating, proper tools, and the "no touch" technique can reduce haematoma and seroma rates.
Tips to reduce iatrogenic rupture: not allowing sharp instruments like scalpels or needles to touch the device; not applying excessive force to a small area of the shell when inserting the device; making a reasonable incision to accommodate the implant's style, size, and profile; and avoiding device wrinkles or folds during implantation.
Reduce bad animations
Post-augmentation animation is unexpected. The implant pocket may shift unnaturally during muscular action if the distal/medial origin of the pectoralis muscle is not appropriately separated. Selective fiber release with a pectoralis major division 2–3 cm above the inframammary fold line and along the sternum could reduce this problem.
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