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of fluid rather than the implant filler. The process may or Eight months following augmentation mammoplasty, she
may not proceed or follow with an incidence of trauma or presented with spontaneous autoinflation of her right
injury. Early known causes of autoinflation of breast are side. There was no recollectable history of trauma or
infection, haematoma or seroma with a reported incidence injury. She was treated with antibiotics, cold compress,

of 0.5% and 0.7% respectively. [5,6] Causes of late onset of support garments and was followed up with regular
autoinflation of breasts are many but these are not clearly intervals. The swelling gradually subsided within 2
defined on the basis of its aetiology, type of implants or site months without surgical intervention and there was no
of accumulation of the fluid. Autoinflation of breasts may recurrence for 8 years [Figure 1].
or may not be associated with implant rupture. Rupture of
silicone implants is normally silent and rarely leads to loss Case 2
[7]
or increase in volume. Ruptures may also present with loss A 25-year-old mother of 1 child showed interest in
[8]
of shape or consistency or axillary lymphadenopathy. [9,10] augmentation mammoplasty following the loss of volume
Implant rupture may occasionally present as spontaneous of her breasts. Augmentation mammoplasty was carried
autoinflation of the breast. [11-13] In contrast saline implant out using 310 TRM Allergan Natrelle INSPIRA cohesive gel
can deflate following its rupture. Rarely a saline implant silicone textured round implants in muscle splitting pocket.
can present with autoinflation of the breast without a She had an uneventful recovery and all settled well. Eight
rupture or breach in the shell of the implant. [14] months following her surgery, she presented with quick
onset autoinflation of her right breast. She was treated
The presentation of anaplastic large cell lymphoma (ALCL) conservatively with antibiotics, cold compress and support
following augmentation mammoplasty also presents as an garment. The swelling subsided in 8 weeks without surgical
autoinflation of the breast. There is increasing awareness of intervention and without recurrence for 6 years [Figure 2].
ALCL which merits special attention.

The current article looks at the management and
presentation of three patients. These patients presented
with spontaneous autoinflation of the breasts due to late
seroma. Also included is literature search to discuss various
causes, locations and type of the texturing of the devices for
the development of autoinflation of breast.
METHODS

A retrospective review was performed of the available
charts for 2,772 consecutive bilateral primary, secondary
augmentation mammoplasties and mastopexy with
augmentation mammoplasties performed by the author
between April 1999 and February 2015. Each breast was Figure 1: (a) Preoperative picture of a 34-year-old patient; (b) six weeks
taken as a single unit for a total of 5,544 breasts. following augmentation mammoplasty with 605 TRF Allergan Natrelle
textured implants; (c) the patient presented with massive right-sided swelling
8 months following mammoplasty; (d) two months following presentation
RESULTS with autoinflation due late seroma. The patient was treated conservatively

There were 2,334 patients in primary augmentation
mammoplasty, 258 in secondary augmentation mammoplasty
and 180 in simultaneous mastopexy with augmentation
mammoplasty groups. A total of 3 autoinflation of breasts
due late seroma were identified in the series [Table
1]. All patients presented at least 6 months following
augmentation mammoplasty and all had textured implants
place in muscle splitting submuscular pocket. There was
no autoinflation due to late seroma noted in secondary
augmentation mammoplasty or simultaneous mastopexy
with augmentation mammoplasty. All patients were treated
conservatively without a recurrence.

Case 1
A 34-year-old mother of 2 children was interested in breast Figure 2: (a) Preoperative picture of a 25-year-old patient; (b) six weeks
augmentation procedure. The augmentation mammoplasty following augmentation mammoplasty with 310 TRM Allergan Natrelle
was performed using 605 mL TRF Allergan Natrelle textured implants; (c) the patient presented with right-sided spontaneous
swelling 8 months following mammoplasty; (d) three months following
INSPIRA cohesive gel silicone textured round implants in presentation with autoinflation due to late seroma. The patient was
muscle splitting pocket. She had an uneventful recovery. treated conservatively
32 Plast Aesthet Res || Vol 3 || Issue 1 || Jan 15, 2016