What is it about?

Can we maintain health and aesthetic? a case of a Heart rhythm implantable device (life saving) disruption of a silicon breast implant.

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Why is it important?

Because of the prevalence of breast implants in cosmetic and reconstructive breast surgery and the natural aging of the population, more cases of female patients with silicone breast implants in need of an AICD may be encountered in the future. This case report illustrates the rare but real possibility of breast implant rupture after minor surgical breast manipulations, such as a routine AICD insertion. We suggest keeping in mind the option of breast implants in female AICD candidates, consulting medical and surgical records to validate the plane in which the breast implants are placed, and in case the implants are placed subglandularly with thin soft-tissue coverage, the implant location should be preoperatively marked and careful blunt dissection used in creating the AICD pocket well above the preoperative mark. Inversely, when performing breast augmentation on a patient with an AICD in place, we suggest that in addition to consulting with the patient’s electrocardiologist, the skin quality above and around the device should be assessed, the AICD pocket preoperatively marked, and a subpectoral pocket preferred to reduce the chance of the AICD pocket violation.

Perspectives

Advances in health care and technology create an opportunity to focus on life enhancing in addition to life saving procedures. the aging population sets unique challenges such as the one presented in the paper. Plastic and reconstructive surgery enable us to support the life saving treatments and preserve aesthetics and therefore enhance quality of life in a safe controlled and responsible manner.

Dr Or Friedman
Tel Aviv Sourasky Medical Center

Read the Original

This page is a summary of: Silicone Breast Implant and Automatic Implantable Cardioverter Defibrillator, Plastic and Reconstructive Surgery Global Open, September 2016, Wolters Kluwer Health,
DOI: 10.1097/gox.0000000000001136.
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