Air drainage: an essential technique for preventing breast augmentation-related pneumothorax

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.

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.

None of the study patients experienced pneumothorax.

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.