Where the PIP is the implant?

Area of Science:

• Thoracic Surgery
• Plastic Surgery
• Medical Imaging

Background:

• A 51-year-old woman with a history of breast augmentation and video-assisted thoracoscopic wedge resection of the lung presented for breast implant replacement.
• The patient sought to address volume loss in the right breast, which was initially attributed to the Poly Implant Protheses (PIP) device.

Observation:

• During the planned breast implant replacement, the right subpectoral implant was not found.
• A significant defect was noted in the fifth intercostal space, raising concerns about the implant's location.

Findings:

• A computed tomography (CT) scan of the chest revealed a circular entity within the right pleural cavity.
• Subsequent video-assisted thoracoscopic surgery (VATS) confirmed the entity to be the missing Poly Implant Protheses (PIP) breast implant.

Implications:

• This case highlights a rare but serious complication of breast implants, involving intrathoracic migration.
• It underscores the importance of thorough surgical exploration and advanced imaging in cases of suspected implant displacement.
• The findings emphasize the need for careful patient selection and monitoring following both breast and thoracic procedures.