Breast augmentation is generally a safe and gratifying procedure. However, complications requiring reoperation do occur and must be managed correctly. We have recently encountered a group of augmentation patients with severe contour deformities. In each case expansion was utilized to correct the deformities.

Four patients over the past three years have presented with such problems. Their breasts revealed significant indentations, skin retraction and/or a “truncated” appearance. Two of the patients had previously suffered extrusion of their implants and two had implant removal due to infection. In three cases the deformities were unilateral and in one bilateral. In no case did it appear that capsulectomy and implant placement or replacement alone would suffice. Therefore, following capsulectomy, tissue expansion was utilized to gradually overcome the contour irregularities over several months before placing a permanent breast implant at a second stage. No complications were encountered. All four cases were completed with the two planned procedures. Results were excellent in three cases and satisfactory in one.

Tissue expansion proved invaluable in the management of this subgroup of patients with post-augmentation contour deformities of the breasts and should be considered for use in similar problematic cases.