Preventing Soft Tissue Complications in Secondary Aesthetic Breast Surgery Using Indocyanin Green Angiography

Area of Science:

• Plastic Surgery
• Surgical Innovation
• Microsurgery

Background:

• Secondary cosmetic breast surgery following augmentation carries risks, including nipple-areola complex necrosis.
• Assessing breast tissue perfusion is crucial in revision breast procedures.

Purpose of the Study:

• To evaluate the utility of indocyanine green (ICG) angiography in preventing skin and gland necrosis during secondary breast surgery.
• To identify areas of compromised blood supply in breast tissue after implant removal.

Main Methods:

• Retrospective comparative analysis of 33 patients undergoing secondary breast surgery.
• Intraoperative ICG angiography used in 16 patients to assess breast tissue perfusion post-implant removal.
• Identification and excision of poorly perfused areas in the ICG group.

Main Results:

• 44% of patients in the ICG angiography group showed poor perfusion, particularly with subglandular implants.
• Resection of compromised tissue in the ICG group resulted in uneventful recovery.
• The non-ICG group had a higher incidence of vertical scar dehiscence/necrosis (P=0.04).

Conclusions:

• ICG angiography is a valuable tool for enhancing safety in secondary breast augmentation revision.
• The technique aids in preventing necrosis and improving outcomes, especially when prior surgical details are unknown.
• Subglandular implant placement was significantly associated with vertical scar dehiscence/necrosis.