Anterior intercostal artery flap for implant salvation procedure in aesthetic breast surgery. Case report

Abstract

Implant exposure (IE) is a rare but devastating complication of aesthetic surgery owing to its psychological and economic implications for patients. In cases of IE, the most reliable strategy is implant removal; however, most patients do not prefer this option. In the absence of prosthetic contamination, salvage procedures are a viable option, with promising success rates.Once IE is detected, the cutaneous defect cannot be treated with direct closure. If additional tissue is needed, the anterior intercostal artery perforator (AICAP) flap can be harvested, using the inframammary fold as a donor site, with minimal aesthetic implications. AICAP flaps can cover defects over the entire lower mammary pole and are useful as deep reinforcement for breast-slimmed flaps.We report a case of augmentation mastopexy in a patient with grade I tuberous breasts. The undeveloped lower mammary pole led to delayed IE at 33 days after surgery. No signs of contamination were observed, and the cutaneous defect was covered with an AICAP flap. Antibiotic instillation was established for 24 h, and oral antibiotic therapy was administered for 3 weeks. Seven months later, a dog-ear deformity of the lateral inframammary fold and excess skin on the flap were excised, resulting in a good aesthetic outcome.

Keywords

• Intercostal artery flap
• Implant exposure
• Implant salvage
• Breast augmentation
• Mastopexy