Probably the most distressing complication is an exposed implant. Once the implant has become exposed, it needs to removed, allowed to heal and reimplanted 3-6 months later. The cause can be from infection, untreated hematoma, or wound breakdown from implant pressure. For very thin patient’s coverage of the implant is important in preventing this devastating complication. Often times, the periareolar incision may be a better choice for incision than the inframammary approach because there is less chance of pressure necrosis of the incision. Replacing the implant after it has had a chance to heal can be challenging. It is best to wait until all the scar tissue subsides before replacing the implant. Even though waiting helps, there is always scar tissue present and replacement is always more difficult than the initial surgery. Often times it is better to use a different access incision from the first surgery to minimize the amount of scar tissue that is encountered. Although recurrence is rare, if the surgery is not planned properly, it can fail.
This patient 2 years after breast augmentation developed infection and implant became exposed. Implant removed and shows marked asymmetry. After 6 months left implant replaced and although there is improvement you can see there is still asymmetry.
