Salvage of Exposed Breast Implant Using Capsular Flaps

Objective: Extrusion represents potential complications associated with the use of breast implants. Attempts to salvage the exposed implants are rarely successful when poor tissue coverage or radiotherpy is present and therefore removal of implant and wound healing are mandatory. In these refractory complicated cases the use of capsular flaps can represent a useful tool to save the implant and achieve definitive healing. Methods: Capsular flaps have been performed on 6 patients with implant extrusion and 11 patients with breast contour deformities over the last 6 years. The authors describe an innovative technique using capsular flaps which are harvested from thicker viable tissues and inset in multiple layers into the fistula tract to reinforce the breast envelope and prevent recurrence of implant extrusion. Results: Complete healing and implant salvage were achieved in all patients treated. No major complications occurred and only minor contour deformities, that regressed spontaneously after surgery, were observed for 2 weeks. Conclusions: Although capsular flaps have been previously described to correct breast shape deformities, no previous report has yet suggested its utility in breast implant salvage in case of extrusion. The authors advocate the use of capsular flap to save the exposed breast implant especially when poor tissue coverage is present and other surgical options to save the implant have already failed.