When Implants Fail: Mastopexy and Large Volume Autologous Fat Grafting, a New Alternative
Augmentation mammoplasty continues to be one of the most commonly performed aesthetic procedures by plastic surgeons worldwide. As newer generations of implants address past concerns, the fact that this is a man-made medical device with a finite lifespan remains unchanged.
When implant failure does occur, it may be due to capsular contracture, breast ptosis and/or soft tissue failure. We report our experience addressing implant failure with explantation, mastopexy and fat grafting.
Methods/Technique:
This is a retrospective review of the senior author’s experience between 2007 to 2013 with mastopexy and large volume autologous fat grafting as an alternative approach to implant exchange in patients with implant failure. Twenty one patients were included in our experience. The indications for the procedure included implant failure, breast ptosis and dissatisfaction with breast appearance with implant.
Patients underwent standard Wise pattern mastopexy after implant explantation with fat grafting after harvest and preparation with low speed centrifugation and were followed up at 2, 4 and 6 weeks post-operatively then every 3 months. Patients were followed clinically and photographically for development of fat necrosis, oil cyst and overall breast appearance and satisfaction
Results/Complications:
All breasts were non-ptotic, soft with no evidence of fat necrosis or oil cysts post-operatively. Three patients underwent a subsequent fat grafting session to increase breast volume. One was 12 months after first session; the second was at four months and the third at 23 months.
Conclusion:
Implant failure is an inevitable complication of breast augmentation, often accompanied by other concern such as soft tissue failure. Mastopexy and large volume autologous fat grafting is a viable option that should be considered in patients with implant failure that no longer desire implants. This alternative procedure allows for creation of an aesthetically pleasing breast with volume comparable to that of the explanted implant.