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Aesthetic Plast Surg. 2007 Jan 4; [Epub ahead of print] Air Drainage: An Essential Technique for Preventing Breast Augmentation-Related Pneumothorax. · Fayman MS. Rosebank Clinic, P.O. Box 1708, Parklands, 2121, Johannesburg, South Africa, info@doctorfayman.co.za. BACKGROUND: Pneumothorax is one of the most poorly understood and least frequently reported complications associated with breast augmentation, yet this complication presents as a dramatic and often extremely distressing event to both the patient and the surgeon. In addition, this complication is associated with an estimated 10% occurrence of medicolegal consequence. A recent survey of 363 Californian Plastic Surgeons concerning the occurrence and outcome of breast augmentation related Pneumothorax suggested that the incidence of this complication could be more prevalent than previously reported. The author previously suggested barotrauma as the underlying mechanism responsible for the development of pneumothorax associated with breast augmentation. This study aimed to analyze the role of air drainage in preventing pneumothorax during insertion of breast implants. METHODS: A control group of five patients who experienced pneumothorax was compared with a group of six consecutive patients whose surgical pocket was drained of air during insertion of the implant. RESULTS: None of the study patients experienced pneumothorax. CONCLUSIONS: Air drainage from the surgical cavity during insertion of the implant is extremely successful in preventing the development of breast augmentation-related pneumothorax. It is suggested that air drainage be introduced as a routine step in breast augmentation procedures, particularly in those that involve insertion of large implants through small incisions. PMID: 17205258 [PubMed - as supplied by publisher] |
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Plast Reconstr Surg. 2005 Sep 15;116(4):1122-6; discussion 1127-8 Pneumothorax as a complication of breast augmentation. · Osborn JM, · Stevenson TR. Division of Plastic Surgery, University of California, Davis, School of Medicine, Sacramento, California, USA. osborn@pscmail.com BACKGROUND: Pneumothorax is a recognized complication of breast augmentation which, until now, was thought to be rare. The authors hypothesize that it is more common than generally appreciated. METHODS: A fax survey was sent to 363 members of the California Society of Plastic Surgeons in 2001, questioning their experience with this complication. RESULTS: The survey response rate was 50 percent, revealing that one in three members of the California Society of Plastic Surgeons had at least one patient who experienced a pneumothorax, and one in 10 had experienced two or more complications of pneumothorax while performing breast augmentation. Sixty-two members reported a total of 83 separate pneumothoraces in their career. No local or hypodermic needle injections were used in 24 percent of these patients. Fifty-five percent of patients were hospitalized, with 71 percent of the cases paid for by insurance companies. Treatment consisted of observation and repeated chest radiograph in 33 percent, needle aspiration alone in 16 percent, and chest tube insertion in 47 percent. CONCLUSIONS: The cause is difficult to determine, but causes suspected by respondents included intraoperative laceration of the pleura (43 percent), needle puncture at the time of local injection (37 percent), ruptured pulmonary blebs during or after the procedure (16 percent), and high anesthetic ventilation pressures (3 percent). The authors believe the complication of pneumothorax is more common than generally appreciated and is not necessarily caused by negligence. The authors now include this complication in their consent form and recommend keeping an intracatheter, pigtail catheter, or Heimlich valve in surgical facilities for treatment of a possible tension pneumothorax. PMID: 16163105 [PubMed - indexed for MEDLINE] |
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