Two important studies ...... Pneumothorax as a complication of breast augmentation

Note from Ilena Rosenthal: Since I put these out to my support groups
earlier this week, I have heard from several women sharing their
experiences that mirror those below.

www.BreastImplantAwareness.org/
www.BreastImplantAwareness.org/blog.htm



http://www.ncbi.nlm.nih.gov/entrez/q..._uids=16163105
Pneumothorax as a complication of breast augmentation.

* Osborn JM,
* Stevenson TR.

Division of Plastic Surgery, University of California, Davis, School
of Medicine, Sacramento, California, USA. osborn@pscmail.com

BACKGROUND: Pneumothorax is a recognized complication of breast
augmentation which, until now, was thought to be rare. The authors
hypothesize that it is more common than generally appreciated.
METHODS: A fax survey was sent to 363 members of the California
Society of Plastic Surgeons in 2001, questioning their experience with
this complication. RESULTS: The survey response rate was 50 percent,
revealing that one in three members of the California Society of
Plastic Surgeons had at least one patient who experienced a
pneumothorax, and one in 10 had experienced two or more complications
of pneumothorax while performing breast augmentation. Sixty-two
members reported a total of 83 separate pneumothoraces in their
career. No local or hypodermic needle injections were used in 24
percent of these patients. Fifty-five percent of patients were
hospitalized, with 71 percent of the cases paid for by insurance
companies. Treatment consisted of observation and repeated chest
radiograph in 33 percent, needle aspiration alone in 16 percent, and
chest tube insertion in 47 percent. CONCLUSIONS: The cause is
difficult to determine, but causes suspected by respondents included
intraoperative laceration of the pleura (43 percent), needle puncture
at the time of local injection (37 percent), ruptured pulmonary blebs
during or after the procedure (16 percent), and high anesthetic
ventilation pressures (3 percent). The authors believe the
complication of pneumothorax is more common than generally appreciated
and is not necessarily caused by negligence. The authors now include
this complication in their consent form and recommend keeping an
intracatheter, pigtail catheter, or Heimlich valve in surgical
facilities for treatment of a possible tension pneumothorax.





Aesthetic Plast Surg. 2007 Jan 4; [Epub ahead of print]

http://www.ncbi.nlm.nih.gov/entrez/q...=pubmed_DocSum
Air Drainage: An Essential Technique for Preventing Breast
Augmentation-Related Pneumothorax.

* Fayman MS.

Rosebank Clinic, P.O. Box 1708, Parklands, 2121, Johannesburg,
South Africa, info@doctorfayman.co.za.

BACKGROUND: Pneumothorax is one of the most poorly understood and
least frequently reported complications associated with breast
augmentation, yet this complication presents as a dramatic and often
extremely distressing event to both the patient and the surgeon. In
addition, this complication is associated with an estimated 10%
occurrence of medicolegal consequence. A recent survey of 363
Californian Plastic Surgeons concerning the occurrence and outcome of
breast augmentation related Pneumothorax suggested that the incidence
of this complication could be more prevalent than previously reported.
The author previously suggested barotrauma as the underlying mechanism
responsible for the development of pneumothorax associated with breast
augmentation. This study aimed to analyze the role of air drainage in
preventing pneumothorax during insertion of breast implants. METHODS:
A control group of five patients who experienced pneumothorax was
compared with a group of six consecutive patients whose surgical
pocket was drained of air during insertion of the implant. RESULTS:
None of the study patients experienced pneumothorax. CONCLUSIONS: Air
drainage from the surgical cavity during insertion of the implant is
extremely successful in preventing the development of breast
augmentation-related pneumothorax. It is suggested that air drainage
be introduced as a routine step in breast augmentation procedures,
particularly in those that involve insertion of large implants through
small incisions.

PMID: 17205258 [PubMed - as supplied by publisher]