Capsular Fibrosis and Recurrent Local Infection Following Breast Reconstruction with a Latissimus Dorsi Muscle and an Implant: Removal of the Implant and Correction with Lipofilling

Abstract

A 59-year-old woman underwent delayed breast reconstruction with a latissimus dorsi flap and a 275 cc implant (round moderate, Mentor ^R) 8 years following mastectomy and radiation therapy for invasive breast cancer (Fig. 53.1a, b). Two years after reconstruction, an atheroma was excised in the inframammary fold of the right breast. The implant capsule was unintentionally opened during surgery. Two weeks after surgery the patient developed an infection of the wound. The patient had several more episodes of local infections, which resulted in a fistula connecting the implant pocket and the skin with recurrent drainage through the fistula. Due to recurrent infections and the development of a capsular fibrosis, removal of the implant was suggested (Fig. 53.2a, b).