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SUBACUTE ARTERIAL BLEEDING AFTER SIMULTANEOUS MASTOPEXY AND BREAST AUGMENTATION WITH IMPLANTS: CASE REPORT.

S Vikšraitis, E Zacharevskij, G Baranauskas

    Acta Chirurgiae Plasticae
    |February 16, 2018
    PubMed
    Summary

    This case report describes a rare complication following a combined mastopexy and breast augmentation procedure. A 27-year-old woman experienced subacute arterial bleeding after surgery, which was diagnosed using ultrasonography and confirmed during revision surgery. The bleeding originated from a branch of the internal mammary artery. After removing a 650 mL hematoma, the implant was repositioned, and the patient recovered uneventfully. The authors highlight the rarity of this complication and stress the importance of postoperative monitoring in such procedures.

    Keywords:
    Breast augmentationaesthetic breast.complicationhematomaaesthetic surgery complicationsinternal mammary arterybreast implant revisionplastic surgery outcomes

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    Area of Science:

    • Aesthetic surgery outcomes research within plastic surgery
    • Complication analysis in reconstructive and cosmetic procedures

    Background:

    Breast augmentation is a widely performed procedure in plastic surgery, aimed at enhancing breast size, shape, or fullness. Implants can be placed under the chest muscles, fascia, or mammary gland. While generally safe, complications can arise. Early issues include infection, seroma, and hematoma, while late complications may involve implant-related problems like rupture or asymmetry. Despite extensive literature on common complications, rare events such as arterial bleeding remain underreported. Prior research has shown that most complications are predictable and manageable. However, the occurrence of subacute arterial bleeding following combined procedures is less documented. This gap motivated the authors to report a unique case of arterial bleeding after simultaneous mastopexy and breast augmentation. No prior work had resolved the exact mechanism or frequency of such events. This paper contributes to the understanding of rare but significant complications in aesthetic surgery.

    Purpose Of The Study:

    The purpose of this study was to document and analyze a rare complication following a combined mastopexy and breast augmentation procedure. The authors aimed to investigate the occurrence of subacute arterial bleeding in a patient who had undergone simultaneous procedures. They sought to describe the clinical presentation, diagnostic process, and management of the complication. The study aimed to raise awareness among surgeons about the possibility of arterial bleeding in such procedures. The authors also intended to highlight the importance of careful postoperative monitoring. By presenting this case, they hoped to contribute to the existing literature on rare complications in aesthetic surgery. The motivation stemmed from the lack of detailed reports on arterial bleeding in this context. This case adds to the limited evidence on uncommon postoperative events.

    Main Methods:

    The study involved a case report of a 27-year-old woman who underwent simultaneous mastopexy and breast augmentation with silicone implants. The patient presented with worsening swelling and pain in the right breast. The authors used ultrasonography to assess the nature of the fluid accumulation around the implant. Based on the imaging findings, a revision surgery was performed to remove a hematoma of 650 mL. During the procedure, the source of the bleeding was identified as a branch of the internal mammary artery. The implant was repositioned after the revision surgery. The patient's postoperative recovery was closely monitored. The authors documented the clinical course, diagnostic approach, and surgical intervention in detail. This method allowed for a comprehensive analysis of the rare complication.

    Main Results:

    The patient experienced subacute arterial bleeding following a combined mastopexy and breast augmentation procedure. Ultrasonography revealed a 2.5 cm heterogeneous fluid collection around the implant. Revision surgery confirmed the presence of a 650 mL hematoma. The source of the bleeding was identified as a branch of the internal mammary artery. The implant was successfully returned to its original position after the revision. The postoperative period was uneventful, with no further complications reported. This case highlights the rarity of arterial bleeding in such procedures. The findings suggest that even with careful surgical technique, rare vascular complications can occur. The results emphasize the importance of thorough postoperative monitoring. The case provides a detailed account of a rare but significant complication.

    Conclusions:

    The authors concluded that subacute arterial bleeding is an extremely rare complication following simultaneous mastopexy and breast augmentation with implants. The case presented demonstrates the importance of recognizing and managing such rare events. The findings suggest that even with meticulous surgical planning, unexpected vascular complications can occur. The authors emphasized the need for careful postoperative monitoring in patients undergoing combined procedures. The study contributes to the limited literature on rare complications in aesthetic surgery. The results highlight the value of diagnostic imaging in identifying the source of bleeding. The authors did not propose any new treatment protocols based on this single case. The conclusions reflect the specific findings of this case report.

    The main outcome is subacute arterial bleeding following simultaneous mastopexy and breast augmentation with silicone implants, which was identified as a branch of the internal mammary artery.

    The hematoma was diagnosed using ultrasonography, which revealed a 2.5 cm heterogeneous fluid collection around the implant.

    Revision surgery was necessary to remove the 650 mL hematoma and identify the source of bleeding, a branch of the internal mammary artery.

    Diagnostic imaging, specifically ultrasonography, was crucial in identifying the fluid accumulation around the implant before surgical intervention.

    The postoperative period was uneventful, with the implant successfully returned to its original position and no further complications reported.

    The authors suggest that subacute arterial bleeding is an extremely rare complication, emphasizing the need for careful postoperative monitoring in similar procedures.