In relatively rare cases after implant reconstruction surgery, the surface of the implant or tissue expander comes through the skin and becomes exposed. This is called “extrusion.”
Causes of breast implant extrusion
Extrusion can happen for the following reasons:
- The skin over the implant thinned too much, leaving too little coverage for the implant. The breast skin could have been thinned by radiation therapy and/or when tissue was removed during the mastectomy. In some cases, the implant used to reconstruct the breast is too large, putting too much pressure on the skin.
- The incision from the mastectomy (which also may have been used for a separate reconstruction surgery) did not heal well and broke open, allowing the implant to emerge. The incision may have broken down because of an infection, pressure from a hematoma (a build-up of blood where tissue was removed during surgery), or from tightening of the skin due to capsular contracture.
- There was a wound on the breast skin after the mastectomy or reconstruction surgery — for instance, an area where the skin died (“skin necrosis”) — and then when the scab came off, that left the implant exposed.
Corrective surgery options for extrusion
You may develop an infection if you have an extruded or exposed implant. If your breast implant has already extruded or is about to extrude, your plastic surgeon will have to remove it. Then, if you’re still undergoing any radiation therapy or chemotherapy treatments, it’s best to wait until you finish those treatments before you get another breast reconstruction surgery.
After that, your options for reconstruction will depend on your individual situation. For instance, you may choose to have your breast reconstructed with an implant if you have enough healthy skin and tissue to support and cover the implant. Your plastic surgeon might suggest that you first have a tissue expander (which stretches the skin to make room for the final implant) inserted for a few months.
If you don’t have enough skin to stretch over an implant or the skin is somewhat thin, the best option may be to reconstruct the breast with a flap of tissue from another place on your body. This is called "autologous reconstruction" or "flap reconstruction." A flap can provide a healthy, soft layer of tissue underneath the skin that helps to protect it. In some cases, your plastic surgeon may recommend including a breast implant beneath the flap to add more volume. Learn more about autologous reconstruction.