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Post-traumatic Breast Implant Complications: Characterizing Injury Mechanisms Using The Nationwide Readmission Database
Jade E. Smith, BA1, Noelle Garbaccio, BSc
1, Dorien I. Schonebaum, BSc
1, Lacey Foster, BSc
1, Morvarid Mehdizadeh, BA
1, Justin J. Cordero, BSc
1, Jose Foppiani, MD
2, Henry Marsh, MD
2, Umar Choudry, MD
2, Samuel J. Lin, MD, MBA
1.
1Beth Israel Deaconess Medical Center, Boston, MA, USA, 2Department of Plastic and Reconstructive Surgery, University of Minnesota, Minneapolis, MN, USA.
PURPOSE: Post-traumatic breast implant and tissue expander (TE) complications are underexplored, leaving providers with limited diagnostic guidance. This study uses the Nationwide Readmission Database (NRD) to examine mechanisms of injury (MOIs) contributing to implant and TE complications and to characterize clinical presentations.
METHODS: The NRD (2017-2020) was queried for cases of post-traumatic breast implant or TE complications. Eligible cases included admissions with a trauma ICD-10 code that preceded or accompanied a breast implant complication (eg. rupture, displacement) or related surgical procedures. Descriptive statistics summarized trauma MOI and clinical presentations.
RESULTS: Of 573 patients, 488 had breast implants and 85 had TEs. The most common MOIs were falls (53.2%) and transportation incidents (25.0%), with less frequent MOIs including contact with animals (3.0%) and firearm injuries (3.0%). Notable incidents included “struck by cow” and “fall from watercraft.” Transportation incidents were more common with implants (27.6% vs 9.6%, p < 0.05), while burns were more common with TEs (20.5% vs 4.9%, p < 0.05). Clinical presentations included rib/clavicle fractures (21.1%), thoracic injuries (12.9%), breast deformity (12.6%), and hemo/pneumothorax (10.1%). At the trauma visit, 78.2% of patients were diagnosed with implant rupture or underwent a procedure, most commonly removal (95%).
CONCLUSION: This study highlights the diverse MOIs and clinical presentations associated with post-traumatic breast implant and TE complications. The findings emphasize the need for a high index of suspicion for implant-related complications, particularly with falls, transportation incidents, or burns.
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