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Gross Anatomy: Breast Implant Makes a Break for It

— Interthoracic migration not unheard of

MedpageToday
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A woman, 36, presented with a partial small bowel obstruction, and a history of cystic fibrosis. Her obstruction resolved with standard treatment, and the discharge process began. In the midst of having a good laugh, she started to cough, and ... jostle.

The woman looked down. One of her breast implants had gone missing, , and , of the University of Kansas Hospital in Kansas City, reported in .

She had undergone a right upper lobectomy for persistent lung infiltrates and chronic infections 8 months previously, and breast augmentation 13 years before.

Apparently, those two surgeries don't mix well. According to the authors, there have been seven other reports of implant migration following thoracic surgery.

"This had happened intermittently before," the authors wrote of their patient. "But the implant would always return to proper position with Valsalva maneuver."

Not this time. The implant was nowhere to be found so a thoracic CT was ordered.

The scan showed the right implant had wandered into the right chest cavity, and a small pleural effusion on the right gave cause for concern that the implant was leaking.

In an exploratory surgery, plastic and cardiothoracic surgeons found a 5 x 3 cm hole in the thoracic wall, through which the implant had migrated.

The surgeons closed the defect and advised the patient against replacing the implant. No mention was made of the fate of the left implant.

For more Gross Anatomy:

Primary Source

CHEST

Doyle S, et al "Intrathoracic migration of a breast implant in a patient with cystic fibrosis" CHEST 2015; DOI: 10.1378/chest.2242905.