Extrusion is when the implant comes through the skin due to a compromise of skin
loss or necrosis (tissue
death). This may occur
when an incision has not completely healed closed, or if the breast tissue
covering your implants weakens. Compromise of the blood supply can directly be
linked to necrosis or loss of tissue around the breast surgical incision which
can be connected to extrusion. This complication, extrusion requires
additional surgery and possible removal of the implant, which may result in
additional scarring and / or loss of your breast tissue. Smoking can lead
to a compromised blood supply due to the fact that
smoking deprives the tissue
of oxygen in order to heal.
Procedures that combine
surgical procedures such as breast augmentation along with breast lift (mastopexy)
at the same time tend to have a higher risk of possible implant extrusion.
There are many plastic surgeons who like to perform these two procedures
separate for just this reason. Having the patient get their mastopexy first,
let it heal for a several months and then go back in with the augmentation with
the implant. There are many surgeons though who do perform both procedures
together and never have a problem. Being sensible with the size of the implant
will help tremendously, as the heavier the implant, the more stress that is
going to be put on the lift incisions.
According to both main
implant manufacturers, Allergan and
extrusion occurs in only 1 or 2% of
reconstruction patients, and is somewhat less common with augmentation patients.
Although, considered rare,
extrusion can occur up to 1 to 2% of reconstruction patients using implants.
Patient’s who have undergone reconstruction due to breast cancer and are
receiving radiation therapy has an increase of extrusion. This is because
radiation compromises the breast tissue.