Impending Implant Exposure from Breast Wound Repaired with Explantation/ Raleigh*

This is a 49-year-old woman who was referred to Dr. Lyle for management of a difficult problem involving her right breast. The patient had a prior augmentation mastopexy performed years earlier by another surgeon. She stated that she was bitten by an insect on her right breast and the wound became infected and developed what appeared to be a burn. Upon evaluation, she was found to have a 6 cm x 6 cm full-thickness necrotic wound of the right breast which appeared much like a full-thickness burn. There was mild infection of the skin. Her breast implant was immediately underneath this large scab-like wound. The implant was certainly likely to get exposed. Dr. Lyle treated the patient initially with antibiotic and then performed repair of the wound and removal of her breast implants. The patient actually desired being smaller since she had gained a lot of weight after her Initial procedure so both breast implants were removed and revision of her mastopexy scars were performed to allow for removal of the large eschar which is the term used for dead skin. Her resulting breasts were very pleasing to her with smaller appearance and somewhat lifted. This is a very unusual case but has been encountered in the past. Dr. Lyle has seen difficult cases like this -some involving the use of heating pads after breast surgery which results in full-thickness burns because the patient does not have sensation and does not realize they are burning themselves.