Evaluation of pulmonary function in patients submitted to reduction mammaplasty

Carney, KE; Iwuchkuwu, OC

doi:10.1590/s0100-69912012000200016

Cited by 2 publications

(2 citation statements)

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“…Weight of the breast as a confounding factor has been studied, which demonstrated improvements in PFTs in women following breast reduction. 21–25 Furthermore, the positive correlation between the amount of breast tissue removed and improvement in FVC has been reported. 23 In our study, neither implant size nor implant size-to-body mass index ratio correlated with change in pulmonary function.…”

Section: Discussionmentioning

confidence: 92%

The Objective Effect of Breast Implant Removal and Capsulectomy on Pulmonary Function

Wee

Younis

Boas

et al. 2021

Plastic and Reconstructive Surgery - Global Open

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Background: Breast Implant Illness after aesthetic breast augmentation remains a poorly-defined syndrome. Prior published studies have identified difficulty breathing as a symptom, but definitive improvement in breathing following breast implant removal remains understudied. We hypothesized that patients presenting with breathing symptoms attributed to breast implants would have objective improvement in pulmonary function tests after complete implant/capsule explantation. Methods: A retrospective study of all patients who underwent investigation for symptomatic breast implants by a single surgeon over 2 years was conducted. Paired T-tests were used to compare PFTs before and after surgery. Multivariate analyses and linear regression models were used to examine the impact of patientand implant-related factors, including size and texture on PFT changes. Results: Sixty-nine patients met inclusion criteria. Forced vital capacity (mean pre: 3.67 ± 0.61 L versus post: 3.82 ± 0.55 L), forced expiratory volume (2.78 ± 0.44 L versus 2.89 ± 0.39 L), and peak expiratory flow rate (5.91 ± 1.43 L versus 6.56 ± 0.96 L) were significantly improved postoperatively (P = 0.004, 0.01, 0.0001, respectively). Textured implants were associated with a greater improvement in PFTs after their removal (P = 0.009). Implant size and capsular contracture, even when controlled relative to body mass index, were not independent predictors of improvement.Conclusions: This study demonstrates that patients presenting with symptomatic breast implants with pulmonary complaints had significant improvement in pulmonary function after complete implant/capsule explantation. Forced vital capacity, forced expiratory volume, and peak expiratory flow rate consistent with a restrictive pattern of ventilation reliably improved in this symptomatic cohort. Textured implants were a significant predictive variable for improvement in pulmonary function.

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Section: Discussionmentioning

confidence: 92%

The Objective Effect of Breast Implant Removal and Capsulectomy on Pulmonary Function

Wee

Younis

Boas

et al. 2021

Plastic and Reconstructive Surgery - Global Open

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“…The effect of breast hypertrophy on pulmonary function has been studied in multiple studies. [4][5][6][7][8] The relief of weight can have a beneficial effect on pulmonary function. Another etiology for improvement may be the relief of scarring on chest wall in improving chest wall mechanics in breathing.It is important to note that for these patients, the decision to explant is challenging.…”

mentioning

confidence: 99%

Reply: Does a Capsulectomy Really Improve Pulmonary Function in Women with Breast Implant Illness?

Feng¹,

Kumar

2021

Plastic and Reconstructive Surgery - Global Open

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W e thank Dr. E. Swanson for his comments regarding our recent publication. 1 The purpose of studying respiratory function in this group of breast implant illness patients was due to the clinical observation that they could breathe better and more deeply with less effort after implant removal and capsulectomy. We developed a quantitative symptomatic data tool to study the outcomes of explantation with capsulectomy. 1 These studies were our attempt to provide evidencebased information about this specific group of patients. 2,3 The improvement in pulmonary function experienced by these patients may have many complex etiologies. One of these may be the weight on the chest. The effect of breast hypertrophy on pulmonary function has been studied in multiple studies. [4][5][6][7][8] The relief of weight can have a beneficial effect on pulmonary function. Another etiology for improvement may be the relief of scarring on chest wall in improving chest wall mechanics in breathing.It is important to note that for these patients, the decision to explant is challenging. Not only do they feel that they have to undo an augmentation surgery that they once desired, but they also have to face potential deformity resulting from years of implantation. Their decision is purely based upon the possibility that their health could be improved.The diagnosis of breast implant illness is also not an easy one. These 11 symptoms can mimic Lyme disease, hypothyroidism, menopause, autoimmune disease, or multiple sclerosis. The diagnosis of breast implant illness is based upon a diagnosis of exclusion and improvement of symptoms following implant removal and capsulectomy.This study is not a randomized controlled study comparing implant removal with capsulectomy versus implant removal without capsulectomy. This type of study is ideal, but clinically challenging to execute practically. Total capsulectomy can be associated with increased complications. We did not report any complications from the 750-patient or 72-patient cohort related to pneumothorax complication. There is a clearly defined plane between the capsule and the external intercostal muscle. When you separate the capsule from the external intercostal muscle and you preserve this muscle, pneumothorax can be avoided. Bleeding complications have occurred, but in less than 1% of the group.

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Evaluation of pulmonary function in patients submitted to reduction mammaplasty

Cited by 2 publications

References 1 publication

The Objective Effect of Breast Implant Removal and Capsulectomy on Pulmonary Function

The Objective Effect of Breast Implant Removal and Capsulectomy on Pulmonary Function

Reply: Does a Capsulectomy Really Improve Pulmonary Function in Women with Breast Implant Illness?

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