Dr. Vu explains that complications such as infection, abscess formation, prolonged wound healing, and excessive fluid accumulation may require extended courses of high-dose antibiotics. Although this can relieve symptoms such as pain and inflammation, inadequate management can lead to persistent subclinical infections. Over time, this allows the accumulation of infected fluids, clotted blood, and adhesive pseudomembranes, making reimplantation impossible.
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Breast implant removal surgery is not a simple procedure. Photo courtesy of Dung Ho |
Dealing with complications
In cases of severe infection, a secondary surgery may be required. This includes cleaning the implant pocket, collecting samples for antibiotic sensitivity testing, inserting drainage systems for monitoring, and irrigating the cavity to stabilize and remove infection.
Other complications, such as capsular contracture, implant rupture, or implant pocket abnormalities caused by textured or smooth implants, require specific surgical techniques for safe removal.
In some cases, residual gel, excessive tissue resection, or improper pocket adhesion after implant removal can lead to inflammation, making it difficult to place implants in future procedures. If left untreated, such inflammation can prolong wound healing and delay recovery.
If internal inflammation is not treated thoroughly, it can lead to delayed or incomplete wound healing. For open wounds, improper care can lead to cross-contamination from external sources, delaying or preventing recovery. Prolonged inflammation not only prevents wound healing but negatively affects the patient’s overall health and immune system.
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Breast implant removal procedure with laryngeal mask anesthesia. Photo courtesy of Dung Ho |
Advances in anesthesia and surgical techniques
Laryngeal mask anesthesia is increasingly preferred for breast implant removal surgery.
This method reduces airway irritation and minimizes the risk of laryngeal trauma, offering patients a more comfortable recovery with fewer side effects compared to traditional endotracheal intubation.
Ultrasonic scalpels are also used during these procedures to ensure minimal tissue damage, bloodless surgery and non-traumatic removal of the implant pocket.
Postoperatively, patients experience minimal pain, can often be discharged within six hours, and do not require additional pain medication or antibiotics.
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Inflammatory cavity management case: debridement, debridement and irrigation of soft tissue abscess. Photo courtesy of Dung Ho |
Case studies in complication management
One patient, TT, 35, experienced complications after multiple implant procedures. Her original implant in April 2022 resulted in an abscess and removal. A second implant in December 2023 resulted in fluid accumulation, requiring removal and drainage.
In December 2024, after a chest ultrasound and negative infection test results, T. sought reimplantation. During the operation, Dr. Vu discovered pseudomembranes and yellow discharge in the implant pocket, indicating poor cavity hygiene and inflammation.
In addition, the entire left pectoral muscle below ribs 4, 5, and 6 remained intact and uncut. The physician contacted the patient’s family to agree on the approach, which included removal of all indentations and partial excision of the pouch in the lower regions of both the right and left sides. The cavity was then irrigated with hydrogen peroxide and Betadine, followed by a thorough saline flush. Postoperative irrigation drains were placed and pseudomembranes were collected for antibiotic sensitivity testing, histopathological analysis, and bacterial tuberculosis examination.
Another patient underwent breast augmentation and bulb reduction in November 2024 but experienced symptoms of pain, swelling and ten days after returning to the cosmetic center for suture removal, developed fever, bitter taste in mouth and chills and was prescribed intravenous antibiotics, from oral antipyretic and anti-inflammatory drugs.
Three days later, during a follow-up exam, the doctor noticed abnormalities, including yellow fluid draining from the cavity. The decision was made to remove the breast implants, leave the wound open without placement of a drain, and continue the prescribed oral medications.
After consultation with Vu and clinical examination, the doctor noticed faint red fluid draining from the cavity through the open incision, which was in direct communication with the implant pocket. Dr. Vu ordered tests to evaluate the infection and develop an appropriate treatment plan, followed by continuous wound irrigation for seven days at the center.
Due to her weakened immune system following multiple surgeries, a non-surgical approach was taken to support her recovery and overall health.
Breast implant removal requires meticulous planning and post-operative care to manage complications and reduce the risk of long-term problems. According to Vu, effective management includes maintaining proper wound hygiene, addressing inflammation and monitoring for signs of infection to ensure optimal patient outcomes.
