Whilst perioperative complications of implant-based breast surgery are well described in literature, late complications are comparatively uncommon, including anaplastic large cell lymphoma, late seroma and late haematoma. The latter is rarely reported, and its aetiology remains a subject of ongoing debate with proposed mechanisms including direct trauma and capsular microfracture. We present a case in which low velocity blunt chest wall trauma precipitated concurrent implant rupture and late peri-implant haematoma 17 years following cosmetic breast augmentation (outside the perioperative period), in a patient with severe capsular contracture, requiring complex single-stage revisional surgery. This case contributes to the limited body of evidence on late postoperative complications of cosmetic breast augmentation in particular and implant-based breast surgery in general and highlights the diagnostic challenges inherent to the ‘silent rupture’ phenomenon. Clinicians should maintain a low threshold for implant assessment following blunt chest trauma, regardless of the velocity of the inciting injury.
Krzysztof Sosnowski (Tue,) studied this question.