Nationwide Analysis of Post-traumatic Breast Implant Complications: Predictors of Immediate vs Delayed Diagnosis and...

Post-traumatic breast implant and tissue expander (TE) complications are increasingly relevant as more patients undergo reconstructive or cosmetic breast surgery. Prior studies are limited to case reports, with little known about the mechanisms of injury or timing of clinical recognition.

Using the Nationwide Readmission Database (2017-2020), we identified adults with trauma admissions followed by breast implant-related diagnoses or procedures. Mechanisms of injury (MOI) and clinical presentations were characterized using ICD-10 codes. Patients were classified as having received "immediate" management (diagnosis or procedure during index admission) or "delayed" (on readmission). Cox regression identified predictors of earlier diagnosis or intervention.

A total of 573 patients with post-traumatic implant complications were included (488 breast implants, 85 TEs). Falls were the most common MOI (53.2%), followed by transport accidents (25.0%). TEs were disproportionately associated with burn injuries (20.5% vs. 4.9% in non-TEs). At presentation, 78.2% of patients were diagnosed with implant rupture or underwent surgical correction. Rib or clavicle fractures (21.1%) and breast symptoms (12.6%) were associated with earlier diagnosis, but not with likelihood of surgery. Plastic surgery consultation significantly decreased time to surgery. Age, sex, and ZIP code did not have notable effects on diagnostic and surgical timing.

Post-traumatic breast implant complications often present without breast-specific symptoms, resulting in diagnostic delays. Trauma protocols should include routine breast imaging in patients with implants, especially after transport, burn, or blunt-force injuries. TE patients may be uniquely susceptible to thermal injury and warrant focused preventive counseling.

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