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Marques-Piubelli ML, Lyapichev KA, Fnu A, Adrada B, Stewart J, Hunt KK, Clemens MW, Iyer S, Wu Y, El Hussein S, Xu J, Ok CY, Li S, Pierson DM, Ferrufino-Schmidt MC, Nahmod KA, Yoga A, Hunsicker L, Evans MG, Resetkova E, Qiu L, Khanlari M, Garces SA, Bueso-Ramos CE, Medeiros LJ, Miranda RN. The Spectrum of Non-neoplastic Changes Associated With Breast Implants: Histopathology, Imaging, and Clinical Significance. Am J Surg Pathol 2024; 48:e43-e64. [PMID: 38451836 DOI: 10.1097/pas.0000000000002198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Abstract
Breast implant-associated anaplastic large cell lymphoma has been recognized as a distinct entity in the World Health Organization classification of hematolymphoid neoplasms. These neoplasms are causally related to textured implants that were used worldwide until recently. Consequently, there is an increased demand for processing periprosthetic capsules, adding new challenges for surgeons, clinicians, and pathologists. In the literature, the focus has been on breast implant-associated anaplastic large cell lymphoma; however, benign complications related to the placement of breast implants occur in up to 20% to 30% of patients. Imaging studies are helpful in assessing patients with breast implants for evidence of implant rupture, changes in tissues surrounding the implants, or regional lymphadenopathy related to breast implants, but pathologic examination is often required. In this review, we couple our experience with a review of the literature to describe a range of benign lesions associated with breast implants that can be associated with different clinical presentations or pathogenesis and that may require different diagnostic approaches. We illustrate the spectrum of the most common of these benign disorders, highlighting their clinical, imaging, gross, and microscopic features. Finally, we propose a systematic approach for the diagnosis and handling of breast implant specimens in general.
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Affiliation(s)
| | - Kirill A Lyapichev
- Department of Pathology, University of Texas Medical Branch, Galveston, TX
| | | | | | | | | | | | - Swaminathan Iyer
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston
| | | | - Siba El Hussein
- Department of Pathology, The University of Vermont Larner College of Medicine, Burlington, VT
| | - Jie Xu
- Department of Hematopathology
| | | | | | - Diane M Pierson
- Department of Pathology, Kings Daughters Medical Center, Ashland, KY
| | | | | | - Arthy Yoga
- Houston Methodist, Breast Surgical Oncology, Houston, TX
| | - Lisa Hunsicker
- Revalla Plastic Surgery and Medical Esthetics, Denver, CO
| | | | | | - Lianqun Qiu
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA
| | - Mahsa Khanlari
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, TN
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2
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Keane GC, Keane AM, Diederich R, Kennard K, Duncavage EJ, Myckatyn TM. The evaluation of the delayed swollen breast in patients with a history of breast implants. Front Oncol 2023; 13:1174173. [PMID: 37476374 PMCID: PMC10354431 DOI: 10.3389/fonc.2023.1174173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 06/20/2023] [Indexed: 07/22/2023] Open
Abstract
Breast implants, whether placed for reconstructive or cosmetic purposes, are rarely lifetime devices. Rupture, resulting from compromised implant shell integrity, and capsular contracture caused by constriction of the specialized scar tissue that normally forms around breast implants, have long been recognized, and remain the leading causes of implant failure. It is apparent, however, that women with breast implants may also experience delayed breast swelling due to a range of etiologic factors. While a majority of delayed seromas associated with breast implants have a benign etiology, this presentation cannot be ignored without an adequate workup as malignancies such as breast implant associated anaplastic large cell lymphoma (BIA-ALCL), breast implant associated diffuse large B-cell lymphoma (BIA-DLBCL), and breast implant associated squamous cell carcinoma (BIA-SCC) can have a similar clinical presentation. Since these malignancies occur with sufficient frequency, and with sometimes lethal consequences, their existence must be recognized, and an appropriate diagnostic approach implemented. A multidisciplinary team that involves a plastic surgeon, radiologist, pathologist, and, as required, surgical and medical oncologists can expedite judicious care. Herein we review and further characterize conditions that can lead to delayed swelling around breast implants.
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Affiliation(s)
- Grace C. Keane
- Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, Saint Louis, MO, United States
| | - Alexandra M. Keane
- Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, Saint Louis, MO, United States
| | - Ryan Diederich
- MidAmerica Plastic Surgery, Glen Carbon, IL, United States
| | - Kaitlyn Kennard
- Division of Surgical Oncology, Washington University School of Medicine, Saint Louis, MO, United States
| | - Eric J. Duncavage
- Department of Pathology and Immunology, Washington University School of Medicine, Saint Louis, MO, United States
| | - Terence M. Myckatyn
- Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, Saint Louis, MO, United States
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3
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Vorstenbosch J, Chu JJ, Ariyan CE, McCarthy CM, Disa JJ, Nelson JA. Clinical Implications and Management of Non-BIA-ALCL Breast Implant Capsular Pathology. Plast Reconstr Surg 2023; 151:20e-30e. [PMID: 36194076 PMCID: PMC9797444 DOI: 10.1097/prs.0000000000009780] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
SUMMARY The breast implant capsule is a dynamic structure that forms following the implantation of a device. Although normally benign, increased awareness of breast implant-associated anaplastic large-cell lymphoma (BIA-ALCL) highlights that disease may arise from the capsule. BIA-ALCL presents as a late seroma or mass but explains few of the late seromas found in breast implant patients. To date, many of these seromas lack a clear cause and are often described as "idiopathic." Several benign and malignant breast implant capsular diseases can cause a late seroma or mass, including breast implant-associated squamous cell carcinoma. Similar to early reports of BIA-ALCL, these conditions are rare and largely limited to case reports or series. The purpose of this special topic is to present a narrative review highlighting capsular abnormalities that contribute to the formation of late seroma or mass in an attempt to broaden the differential diagnosis and help plastic surgeons identify the cause. Specifically, we review the presentation and management of BIA-ALCL, synovial metaplasia, capsular epithelialization, late hematoma, double capsule, breast cancer, squamous cell carcinoma, mesenchymal tumor, and B-cell lymphoma. Although rare, plastic surgeons should consider these capsular conditions as causes of late seromas and masses. Usually, these conditions may be diagnosed by following the National Comprehensive Cancer Network screening guidelines for BIA-ALCL. Thorough evaluation and workup of late seromas and masses may lead to improved characterization of these rare breast implant capsular conditions and improve our understanding of their pathophysiology and management.
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Affiliation(s)
- Joshua Vorstenbosch
- Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Jacqueline J. Chu
- Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Charlotte E. Ariyan
- Gastric and Mixed Tumor Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Colleen M. McCarthy
- Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Joseph J. Disa
- Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Jonas A. Nelson
- Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
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4
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Whaley RD, Aldrees R, Dougherty RE, Prieto Granada C, Badve SS, Al Diffalha S. Breast Implant Capsule-Associated Squamous Cell Carcinoma: Report of 2 Patients. Int J Surg Pathol 2022; 30:900-907. [PMID: 35300538 DOI: 10.1177/10668969221086940] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Breast implant augmentation is a low-risk procedure with few life-threatening complications. Capsular contracture and rupture/leakage of the implant are the most common complications encountered. Malignant breast implant augmentation-associated lesions are rare, with anaplastic large cell lymphoma being the most common. Squamous cell carcinomas associated with breast implant augmentation are exceedingly rare, with only eight patients reported. Breast implant capsule-associated squamous cell carcinoma occurs in patients with long standing breast implant augmentations (>11 years). We report two additional patients with breast implant capsule-associated squamous cell carcinoma. Review of the literature reveals that invasion beyond the breast implant capsule into the adjacent tissue by the squamous cell carcinoma appears to have negative prognostic implications, and possibly warrants close clinical follow-up.
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Affiliation(s)
- Rumeal D Whaley
- 12250Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Rana Aldrees
- 9968Department of Pathology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Rae E Dougherty
- 12250Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Carlos Prieto Granada
- 9968Department of Pathology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Sunil S Badve
- 12250Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Sameer Al Diffalha
- 9968Department of Pathology, University of Alabama at Birmingham, Birmingham, AL, USA.,Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA
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5
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Lee JH, Hong HK, Kim WH, Kim HJ, Lee J, Park HY, Yang JD, Lee JS. Delayed unilateral hematoma after reconstructive and aesthetic breast surgery with implants in Asian patients: two case reports. Gland Surg 2021; 10:1515-1522. [PMID: 33968703 DOI: 10.21037/gs-20-854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Hematomas represent one of the postoperative complications in patients undergoing reconstructive or aesthetic breast surgery with a silicone implant. Although there are few reports of intracapsular hematoma, those presenting late hematoma after reconstructive and aesthetic augmentation surgeries are rarer. This study reported two Asian patients with late hematoma after reconstruction and aesthetic breast surgery. A 54-year-old female patient underwent bilateral nipple-sparing mastectomy with immediate breast reconstruction using anatomically shaped textured implant for intraductal carcinoma in August 2019. Contralateral nipple-sparing mastectomy was performed for the BRCA gene mutation on the left breast, which was immediately reconstructed with an anatomically shaped textured implant. In a 1-year postoperative magnetic resonance imaging evaluation, an extracapsular hematoma was found on the right side, which was removed following the removal of both implants. Another case was a 63-year-old female patient who underwent augmentation of both breasts with smooth round implants and experienced right unilateral swelling and painless firmness about 30 years postoperatively. A preoperative magnetic resonance imaging evaluation showed both intracapsular and extracapsular ruptures on the right breast and a bulging implant herniation on the left breast. During the operation, hematoma, implants, and capsule were all removed. The excised capsule was sent for histological evaluation. Slightly dark colored blood was emptied before removing the semisolid-state intracapsular hematoma. In both cases, the patients responded well postoperatively and were discharged to their homes with no postsurgical complications, including seroma, or additional hematoma on the breasts. The etiology of late hematoma following breast augmentation or reconstruction has been poorly characterized. Further reports are needed to clearly establish the reasons for this increase in late hematoma formation.
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Affiliation(s)
- Jong Ho Lee
- Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Hyun Ki Hong
- Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Won Hwa Kim
- Department of Radiology, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok Hospital, Daegu, Korea
| | - Hye Jung Kim
- Department of Radiology, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok Hospital, Daegu, Korea
| | - Jeeyeon Lee
- Department of Surgery, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Ho Yong Park
- Department of Surgery, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Jung Dug Yang
- Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Joon Seok Lee
- Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University, Daegu, Korea
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6
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Chau AL, Rosas J, Degen GD, Månsson LK, Chen J, Valois E, Pitenis AA. Aqueous surface gels as low friction interfaces to mitigate implant-associated inflammation. J Mater Chem B 2020; 8:6782-6791. [PMID: 32364211 DOI: 10.1039/d0tb00582g] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Aqueous surface gels are fragile yet resilient biopolymer-based networks capable of sustaining extremely low friction coefficients despite tribologically-challenging environments. These superficial networks are ubiquitous in natural sliding interfaces and protect mechanosensitive cells from excessive contact pressures and frictional shear stresses from cell-fluid, cell-cell, or cell-solid interactions. Understanding these complex lubrication mechanisms may aid in the development of materials-based strategies for increasing biocompatibility in medical devices and implants. Equally as important is characterizing the interplay between soft and passive yet mobile implant materials and cellular reactions in response to direct contact and frictional shear stresses. Physically interrogating living biological systems without rupturing them in the process is nontrivial. To this end, custom biotribometers have been designed to precisely modulate contact pressures against living human telomerase-immortalized corneal epithelial (hTCEpi) cell layers using soft polyacrylamide membrane probes. Reverse-transcription quantitative polymerase chain-reaction (RT-qPCR) indicated that increased duration and, to a much greater extent, the magnitude of frictional shear stress lead to increased production of pro-inflammatory (IL-1β, IL-6, MMP9) and pro-apoptotic (DDIT3, FAS) genes, which in clinical studies are linked to pathological pain. The hierarchical structure often found in biological systems has also been investigated through the fabrication of high-water content (polyacrylamide) hydrogels through free-radical polymerization inhibition. Nanoindentation experiments and friction coefficient measurements indicate that these "gradient surface gels" reduce contact pressures and frictional shear stresses at the surface of the material while still maintaining stiffness within the bulk. Reducing frictional shear stresses through informed materials and surface design may concomitantly increase lubricity and quiet the immune response, and thus provide bio-inspired routes to improve patient outcomes and quality of life.
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Affiliation(s)
- Allison L Chau
- Materials Department University of California, Santa Barbara, CA 93106, USA.
| | - Jonah Rosas
- Biomolecular Science and Engineering Department University of California, Santa Barbara, CA 93106, USA
| | - George D Degen
- Department of Chemical Engineering, University of California, Santa Barbara Santa Barbara, CA 93106, USA
| | - Lisa K Månsson
- Department of Physics Chalmers, University of Technology, 412 58 Gothenburg, Sweden
| | - Jonathan Chen
- Department of Chemical Engineering, University of California, Santa Barbara Santa Barbara, CA 93106, USA
| | - Eric Valois
- Department of Molecular, Cellular, and Developmental Biology, University of California, Santa Barbara, CA 93106, USA
| | - Angela A Pitenis
- Materials Department University of California, Santa Barbara, CA 93106, USA.
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7
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Achieving Reliable Diagnosis in Late Breast Implant Seromas: From Reactive to Anaplastic Large Cell Lymphoma. Plast Reconstr Surg 2019; 143:15S-22S. [PMID: 30817552 DOI: 10.1097/prs.0000000000005565] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Late onset of fluid collection surrounding breast implants may represent a serious issue when considering the possibility of breast implant-associated anaplastic large cell lymphoma, a newly recognized type of T-cell malignancy. However, many other factors, including trauma and infections, may be implicated in the formation of non-neoplastic periprosthetic delayed effusions. An appropriate management of late seromas, consisting of ultrasound-guided fluid drainage, cultures, cytology, and immunocytochemical and T-cell clonality studies, should be performed to achieve a correct and prompt diagnosis of breast implant-associated anaplastic large cell lymphoma. Criticisms in the diagnosis of late peri-implant effusions are here discussed in detail.
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8
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Olsen DL, Keeney GL, Chen B, Visscher DW, Carter JM. Breast implant capsule-associated squamous cell carcinoma: a report of 2 cases. Hum Pathol 2017; 67:94-100. [PMID: 28739500 DOI: 10.1016/j.humpath.2017.07.011] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Revised: 06/16/2017] [Accepted: 07/05/2017] [Indexed: 11/30/2022]
Abstract
The use of prosthetic implants for breast augmentation has become commonplace. Although implants do not increase the risk of conventional mammary carcinoma, they are rarely associated with anaplastic large cell lymphoma. We report 2 cases of breast implant capsule-associated squamous cell carcinoma with poor clinical outcomes. Both patients (56-year-old woman and 81-year-old woman) had long-standing implants (>25 years) and presented with acute unilateral breast enlargement. In both cases, squamous cell carcinoma arose in (focally dysplastic) squamous epithelium-lined breast implant capsules and widely invaded surrounding breast parenchyma or chest wall. Neither patient had evidence of a primary mammary carcinoma or squamous cell carcinoma at any other anatomic site. Within 1 year, one patient developed extensive, treatment-refractory, locoregional soft tissue metastasis, and the second patient developed hepatic and soft tissue metastases and died of disease. There are 2 prior reported cases of implant-associated squamous cell carcinoma in the plastic surgery literature; one provides no pathologic staging or outcome information, and the second case was a capsule-confined squamous cell carcinoma. Together, all 4 cases share notable commonalities: the patients had long-standing breast implants and presented with acute unilateral breast pain and enlargement secondary to tumors arising on the posterior aspect of squamous epithelialized implant capsules. Because of both its rarity and its unusual clinical presentation, implant capsule-associated squamous cell carcinoma may be underrecognized. The aggressive behavior of the tumors in this series underscores the importance of excluding malignancy in patients with long-standing breast implants who present with acute unilateral breast pain and enlargement.
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Affiliation(s)
- Daniel L Olsen
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905
| | - Gary L Keeney
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905
| | - Beiyun Chen
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905
| | - Daniel W Visscher
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905
| | - Jodi M Carter
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905.
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9
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Primary Squamous Cell Carcinoma Arising from a Breast Implant Capsule. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2016; 3:e586. [PMID: 26894011 PMCID: PMC4727695 DOI: 10.1097/gox.0000000000000567] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2015] [Accepted: 10/27/2015] [Indexed: 11/27/2022]
Abstract
Primary squamous cell carcinoma (SCC) of the breast comprises less than 0.1% of all breast cancers. Literature review reveals only 1 reported case of an SCC arising from the capsule of a breast implant. The authors describe, herein, a primary SCC arising from the capsule of a long-standing silicone breast implant.
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10
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Peters W, Fornasier V, Howarth D. Late unilateral hematoma after breast augmentation. Plast Surg (Oakv) 2014. [DOI: 10.1177/229255031402200106] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Walter Peters
- Division of Plastic Surgery; Mount Sinai Hospital, and the University of Toronto, Toronto, Ontario
| | - Victor Fornasier
- Department of Anatomic Pathology and Cytology, St Michael's Hospital; Mount Sinai Hospital, and the University of Toronto, Toronto, Ontario
| | - David Howarth
- Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, and the University of Toronto, Toronto, Ontario
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11
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Peters W, Fornasier V, Howarth D. Late unilateral hematoma after breast augmentation. Plast Surg (Oakv) 2014; 22:18-21. [PMID: 25152642 PMCID: PMC4128428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Abstract
BACKGROUND Late hematoma after breast augmentation is a rare phenomenon with unproven etiology. METHODS Five patients presented with a late unilateral hematoma after receiving bilateral, submuscular, smooth, round, silicone gel implants for cosmetic breast augmentation. All patients underwent explantation and capsulectomy. Extensive clinical and histological analysis of all capsules was performed. RESULTS All patients presented with progressive unilateral breast enlargement with at least a doubling of their breast size. Breast enlargement developed nine, 12, 14, 22 and 38 years, respectively, after initial implant insertion and in the absence of any known trauma. Patients presented for treatment one, three, four, nine and 12 months, respectively, after initially noticing breast enlargement. This enabled a sequential analysis of the events occurring on the surface of the capsule and within the structure of the capsule. Macroscopic and microscopic analysis of all capsules demonstrated multiple areas of recent and older hemorrhage, both within the structure of capsules and on the surface of the capsule. Continuing recurrent bouts of acute hemorrhage were observed even nine and 12 months after initial hematoma development. The position of medium-size vessels within the capsules corresponded to the sites of recurrent bleeding within capsules. CONCLUSIONS Late hematomas presented from nine to 38 years after submuscular breast augmentation with a doubling of breast size. Late hematomas appeared to result from multiple recurrent bouts of bleeding within the structure of the capsules. This leads to recurrent bleeding on the surface of the capsules. Breast enlargement develops progressively over time rather than acutely. Continuing acute hemorrhage persisted up to one year after initial hematoma development. This progression suggests a process analogous to a chronic expanding hematoma that has been described in other areas of the body. Failure to remove a capsule could result in long-term continuing bleeding from vessels within the capsule.
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Affiliation(s)
- Walter Peters
- Division of Plastic Surgery, and the University of Toronto, Toronto, Ontario
| | - Victor Fornasier
- Department of Anatomic Pathology and Cytology, St Michael’s Hospital, and the University of Toronto, Toronto, Ontario
| | - David Howarth
- Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, and the University of Toronto, Toronto, Ontario
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12
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Grippaudo FR, Renzi L, Costantino B, Longo B, Santanelli F. Late unilateral hematoma after breast reconstruction with implants: case report and literature review. Aesthet Surg J 2013; 33:830-4. [PMID: 23864111 DOI: 10.1177/1090820x13496249] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
UNLABELLED Although reports of late hematoma after placement of breast implants are rare, there has been a noticeable increase in these reports in recent years. Various etiologies have been proposed, usually relating to history of trauma, anticoagulant use, or physical strain. In this case report, we describe a 61-year-old patient who slowly developed a unilateral intracapsular hematoma 2 years after breast reconstruction with Biocell (Natrelle; Allergan, Inc, Irvine, California) textured implants. This case is unique because of the intraoperative finding of 2 capsules surrounding the implant, with the hematoma between the 2 layers. We also discuss the possible pathophysiological mechanisms of this phenomenon. LEVEL OF EVIDENCE 5.
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13
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Amorous Squeezing of the Augmented Breast May Result in Late Capsular Hematoma Formation. Ann Plast Surg 2008; 60:375-8. [DOI: 10.1097/sap.0b013e31812e6b76] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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