Breast Implant Extrusion

In relatively rare cases, after breast implant reconstruction surgery, the surface of the tissue expander or breast implant pokes through the skin and is exposed. Doctors refer to it as extrusion.

Either breast implant extrusion or tissue expander extrusion can happen for the following reasons.

The skin over the implant has thinned out too much. When the skin covering an implant becomes too thin, there isn’t enough coverage for the implant. Breast skin can be thinned by radiation, by having too much tissue removed during a mastectomy, or both. In some cases, the implant used to reconstruct the breast is too large, putting too much pressure on the skin and stretching it out.

Problems with the mastectomy incision. If the mastectomy incision, which also may have been used for a separate reconstruction surgery, doesn’t heal well and breaks open, the breast implant can become exposed. Problems with an incision may be caused by infection, pressure from a hematoma (a build-up of blood where tissue was removed during surgery), or from tightening of the skin because of capsular contracture.

Problems with the skin after mastectomy or breast reconstruction surgery. If there’s a wound on the breast skin after mastectomy or reconstruction surgery and the scab comes off, it may leave the breast implant exposed.

There is a risk of infection if you have tissue expander or breast implant extrusion. If your expander or implant has already extruded or is about to extrude, your plastic surgeon has to remove it. If you have extrusion while you’re also having radiation or chemotherapy, it’s best to wait until you finish those treatments before you have breast reconstruction surgery again.

Once it’s safe for you to have surgery, if you would like breast reconstruction surgery again, your surgeon can help you decide whether trying again with an implant (and with tissue expanders) makes sense for you. Your surgeon may recommend flap reconstruction if you don’t have enough skin to stretch over an implant or if the skin is too thin.