We report the case of a 32-year-old woman who underwent bilateral subcutaneous mastectomy through expanded periareolar incisions due to severe fibrocystic mastopathy.
The reconstruction was performed by implanting subpectoral expanders, which were replaced at 4 months by anatomical prostheses cohesive silicone gel.
Postoperatively, an area of tissue ischemia with partial necrosis of the left areola was observed.
This complication was managed conservatively by partial debridement at 7 days, because the prosthesis was placed subpectorally.
During the consultation review performed 15 days after the intervention, the patient presented with a left prosthesis exposed through a dehiscence of the pectoralis major muscle, through which the prosthesis was introduced.
No signs of infection were observed.
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The patient was informed of the possible treatments and the breast was surgically reviewed.
Under local anesthesia and sedation we washed the dissected pouch and sedated the prosthesis with 10 % povidone-iodine salt solution and isotonic saline solution.
In the space of implantation of the prosthesis, between the capsule formed and the anterior surface of the prosthesis, in direct contact with it, we placed a resorbable collagen membrane with gentamicin 10 x 10 x 0.5 G® (C).
It was possible to close the wound with local tissues, dissecting the capsule until lifting enough muscle was the ideal one to close in two planes, one deep with the capsule and another superficial with skin and subcutaneous tissue, as would have made difficult the management
We did not leave drainage in the cavity and maintained prophylactic antibiotic therapy based on the finding of the complication in the consultation (Amoxicillin-Clavulanic) until completing 8 days.
During surgery a culture of the wound was performed which was negative.
The patient was discharged 48 hours later.
The subsequent evolution was uneventful.
No contracture was observed at 12 months.
