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Surgical and Multidisciplinary Management of ICD Migration Into the Breast Implant Pocket
Matthew Williams1, Samantha Cervantes Valadez1, Keyvon Rashidi2
1Institute for Reconstructive Surgery, Houston Methodist Hospital, Weill Cornell Medicine, Houston, Texas, USA.
Clinical Condition:
Migration of an implantable cardioverter-defibrillator (ICD) generator into a subpectoral breast implant pocket is a rare complication with potential functional consequences.
Key Questions:
1) What clinical or imaging findings should raise suspicion for migration in patients with breast implants? 2) Which surgical strategies allow safe repositioning while preserving implant integrity and device function? 3) How does multidisciplinary collaboration help prevent recurrence?
Outcome:
The ICD was retrieved from the implant pocket and repositioned into a subpectoral position using native muscular borders and an antibiotic mesh reinforcement. Recovery was uncomplicated, and device function remained normal at follow-up.
Take-Home Messages:
A history of breast augmentation may create an unanticipated pathway for ICD migration. Early recognition and coordinated multidisciplinary planning facilitate stable repositioning and reduce the risk of long-term device complications.
