Transaxillary Capsulorrhaphy with Reimplantation to Correct Bottoming-Out Deformity in Breast Mycobacterial Periprosthetic Infection: A Case Report with Literature Review
Augmentation mammoplasty is one of the most popular cosmetic surgeries, but there is a high reoperation rate (29.7%) commonly due to capsular contracture, implant malpositioning, infection, and unsatisfactory size. Although infection only accounts for 2% of cases, its management is very challenging,...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Thieme Medical Publishers, Inc.
2023-11-01
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| Series: | Archives of Plastic Surgery |
| Subjects: | |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/a-2119-3835 |
| _version_ | 1797383081112371200 |
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| author | Tsung-Chun Huang Jian-Jr Lee Kuo-Hui Yang Chia-Huei Chou Yu-Chen Chang |
| author_facet | Tsung-Chun Huang Jian-Jr Lee Kuo-Hui Yang Chia-Huei Chou Yu-Chen Chang |
| author_sort | Tsung-Chun Huang |
| collection | DOAJ |
| description | Augmentation mammoplasty is one of the most popular cosmetic surgeries, but there is a high reoperation rate (29.7%) commonly due to capsular contracture, implant malpositioning, infection, and unsatisfactory size. Although infection only accounts for 2% of cases, its management is very challenging, especially with nontuberculous mycobacteria (NTM) infection. Breast prosthetic NTM infection is a rare but is a disastrous condition with an incidence of approximately 0.013%. Immediate salvage reimplantation is usually not suggested, and most studies recommend a gap of 3 to 6 months after combination antibiotics therapy before reimplantation. However, delayed reimplantation often leads to great psychological stress and struggle between the doctor and patient. We present the case report of successful reimplantation in treating prosthetic NTM infections in a 28-year-old female. We discuss a novel technique “transaxillary capsulorrhaphy” to correct the bottoming-out deformity. One year after the combination of antibiotics and surgery, the follow-up computed tomography scan showed complete remission of NTM without recurrence. We discuss the surgical technique in detail. The 1-year follow-up assessment (photos and dynamic video) revealed good cosmesis and reliable correction using the new technique. This report is the first formal description and discussion of one-stage reimplantation following NTM infections. Transaxillary capsulorrhaphy allows for a successful salvage operation when an implant is displaced. This approach provides highly favorable result in eastern women undergoing revision augmentation mammoplasty. This study reflects level of evidence V, considering opinions of respected authorities based on clinical experience, descriptive studies, or reports of expert committees. |
| first_indexed | 2024-03-08T21:15:33Z |
| format | Article |
| id | doaj.art-bb111069e277480a93e6a34109cc33c5 |
| institution | Directory Open Access Journal |
| issn | 2234-6163 2234-6171 |
| language | English |
| last_indexed | 2024-03-08T21:15:33Z |
| publishDate | 2023-11-01 |
| publisher | Thieme Medical Publishers, Inc. |
| record_format | Article |
| series | Archives of Plastic Surgery |
| spelling | doaj.art-bb111069e277480a93e6a34109cc33c52023-12-21T23:52:35ZengThieme Medical Publishers, Inc.Archives of Plastic Surgery2234-61632234-61712023-11-01500655756210.1055/a-2119-3835Transaxillary Capsulorrhaphy with Reimplantation to Correct Bottoming-Out Deformity in Breast Mycobacterial Periprosthetic Infection: A Case Report with Literature ReviewTsung-Chun Huang0https://orcid.org/0000-0003-2842-393XJian-Jr Lee1https://orcid.org/0009-0004-4058-2831Kuo-Hui Yang2https://orcid.org/0009-0001-6238-9491Chia-Huei Chou3https://orcid.org/0000-0001-5523-0370Yu-Chen Chang4https://orcid.org/0009-0006-0504-9331Department of Plastic and Reconstructive Surgery, China Medical University Hospital, China Medical University, Taichung, TaiwanDepartment of Plastic and Reconstructive Surgery, China Medical University Hospital, China Medical University, Taichung, TaiwanVirtue Cosmetic Surgery Clinic, Taichung, TaiwanDivision of Infectious Diseases, Department of Internal Medicine, China Medical University Hospital, China Medical University, Taichung, TaiwanDepartment of Surgery, China Medical University Hospital, China Medical University, Taichung, TaiwanAugmentation mammoplasty is one of the most popular cosmetic surgeries, but there is a high reoperation rate (29.7%) commonly due to capsular contracture, implant malpositioning, infection, and unsatisfactory size. Although infection only accounts for 2% of cases, its management is very challenging, especially with nontuberculous mycobacteria (NTM) infection. Breast prosthetic NTM infection is a rare but is a disastrous condition with an incidence of approximately 0.013%. Immediate salvage reimplantation is usually not suggested, and most studies recommend a gap of 3 to 6 months after combination antibiotics therapy before reimplantation. However, delayed reimplantation often leads to great psychological stress and struggle between the doctor and patient. We present the case report of successful reimplantation in treating prosthetic NTM infections in a 28-year-old female. We discuss a novel technique “transaxillary capsulorrhaphy” to correct the bottoming-out deformity. One year after the combination of antibiotics and surgery, the follow-up computed tomography scan showed complete remission of NTM without recurrence. We discuss the surgical technique in detail. The 1-year follow-up assessment (photos and dynamic video) revealed good cosmesis and reliable correction using the new technique. This report is the first formal description and discussion of one-stage reimplantation following NTM infections. Transaxillary capsulorrhaphy allows for a successful salvage operation when an implant is displaced. This approach provides highly favorable result in eastern women undergoing revision augmentation mammoplasty. This study reflects level of evidence V, considering opinions of respected authorities based on clinical experience, descriptive studies, or reports of expert committees.http://www.thieme-connect.de/DOI/DOI?10.1055/a-2119-3835bottoming-out deformitycapsular flaptransaxillary capsulorrhaphymycobacterial infection |
| spellingShingle | Tsung-Chun Huang Jian-Jr Lee Kuo-Hui Yang Chia-Huei Chou Yu-Chen Chang Transaxillary Capsulorrhaphy with Reimplantation to Correct Bottoming-Out Deformity in Breast Mycobacterial Periprosthetic Infection: A Case Report with Literature Review Archives of Plastic Surgery bottoming-out deformity capsular flap transaxillary capsulorrhaphy mycobacterial infection |
| title | Transaxillary Capsulorrhaphy with Reimplantation to Correct Bottoming-Out Deformity in Breast Mycobacterial Periprosthetic Infection: A Case Report with Literature Review |
| title_full | Transaxillary Capsulorrhaphy with Reimplantation to Correct Bottoming-Out Deformity in Breast Mycobacterial Periprosthetic Infection: A Case Report with Literature Review |
| title_fullStr | Transaxillary Capsulorrhaphy with Reimplantation to Correct Bottoming-Out Deformity in Breast Mycobacterial Periprosthetic Infection: A Case Report with Literature Review |
| title_full_unstemmed | Transaxillary Capsulorrhaphy with Reimplantation to Correct Bottoming-Out Deformity in Breast Mycobacterial Periprosthetic Infection: A Case Report with Literature Review |
| title_short | Transaxillary Capsulorrhaphy with Reimplantation to Correct Bottoming-Out Deformity in Breast Mycobacterial Periprosthetic Infection: A Case Report with Literature Review |
| title_sort | transaxillary capsulorrhaphy with reimplantation to correct bottoming out deformity in breast mycobacterial periprosthetic infection a case report with literature review |
| topic | bottoming-out deformity capsular flap transaxillary capsulorrhaphy mycobacterial infection |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/a-2119-3835 |
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