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2023, Number 2

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Cir Plast 2023; 33 (2)

Treatment levels of galactorrhea in breast augmentation with implants: a rare condition with high-impact risk

Ortiz-López JB, Martínez-Mosqueira JR, Vázquez-Armenta MG
Full text How to cite this article 10.35366/112376

DOI

DOI: 10.35366/112376
URL: https://dx.doi.org/10.35366/112376

Language: Spanish
References: 18
Page: 73-80
PDF size: 471.58 Kb.


Key words:

galactorrhea, galactocele, breast augmentation, augmentation mammoplasty, breast implants.

ABSTRACT

Breast augmentation was the most performed aesthetic surgical procedure worldwide according to statistics of the International Society of Aesthetic Plastic Surgery (ISAPS) in 2020. Galactorrhea is a rare complication after breast augmentation with implants, with an incidence of 0.96% and only thirty-eight cases reported in the most recent systematic review in 2021, although with highly significant short and long-term possible consequences. Predisposing factors such as: use of oral contraceptives, psychological stress, use of anti-dopaminergic drugs, approach by periareolar incision and placement of the breast implant in the sub glandular plane have been evidenced. In the period of 5 years (2015-2020) in our clinic in Mexico City we evidenced galactorrhea/galactocele after the placement of breast implants in seven patients (incidence of 0.31%), which required a more complex diagnostic strategy and pharmacological/surgical treatment, which is why we reviewed our own cases and the literature. With the information available, the existing evidence, and our experience, we put forward a guideline for the effective determination of preoperative risk factors, a complete diagnostic approach and effective therapeutic levels to reduce the possible short and long-term complications of galactorrhea/galactocele associated with breast augmentation with implants.


REFERENCES

  1. ISAPS International Survey on Aesthetic/Cosmetic Procedures Performed in 2020; Available in: https://www.isaps.org/media/hprkl132/isaps-global-survey_2020.pdf

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  3. Adams WP. The process of breast augmentation: four sequential steps for optimizing outcomes for patients. Plast Reconstr Surg 2008; 122: 1892-1900.

  4. Adams WP Jr, Culbertson EJ, Deva AK et al. Macrotextured breast implants with defined steps to minimize bacterial contamination around the device: experience in 42,000 implants. Plast Reconstr Surg 2017; 140 (3): 427-431.

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  10. Collado MC, Delgado S, Maldonado A et al. Assessment of the bacterial diversity of breast milk of healthy women by quantitative real-time PCR. Letters in Applied Microbiology 2009; 48: 523-528.

  11. Simao TS. Galactorrhea and galactocele after breast augmentation: diagnosis and treatment algorithm. Plast Reconstr Surg 2021; 147 (5): 915e-916e.

  12. Fidalgo RFT. Galactorrea grave tras aumento mamario con implantes. Cir Plast Iberolatinoam 2012; 38 (2): 169-175.

  13. Wang Y, Tian J, Lui J. Suppressive effect of leukotriene antagonists on capsular contracture in patients who underwent breast surgery with prosthesis: a meta-analysis. Plast Reconstr Surg 2020; 145: 901-911.

  14. Hu H, Jacombs A, Vickery K, Merten SL, Pennington D., Deva AK. Chronic biofilm infection in breast implants is associated with an increased T-cell lymphocytic infiltrate: Implications for breast implant-associated lymphoma. Plast Reconstr Surg 2015; 135: 319-329.

  15. Alex A, Bhandary E, McGuire KP. Anatomy and physiology of the breast during pregnancy and lactation. Adv Exp Med Biol 2020; 1252: 3-7.

  16. Melmed S, Casanueva FF, Hoffman AR et al. Diagnosis and treatment of hyperprolactinemia: an Endocrine Society clinical practice guideline. J Clin Endocrinol Meta 2011; 96 (2): 273-288.

  17. Ballard O, Morrow AL. Human milk composition: nutrients and bioactive factors. Pediatr Clin North Am 2013; 60 (1): 49-74.

  18. Collado M.C., Delgado S, Maldonado A et al. Assessment of the bacterial diversity of breast milk of healthy women by quantitative real-time PCR. Lett Appl Microbiol 2009; 48: 523-528.




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Cir Plast. 2023;33