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CC BY 4.0 · Arch Plast Surg 2023; 50(02): 156-159
DOI: 10.1055/a-2015-8803
Breast/Trunk
Idea and Innovation

Use of Acellular Biologic Matrix Envelope for Cardiac Implantable Electronic Device Placement to Correct Migration into Submuscular Breast Implant Pocket

Peyton Terry 
1   Department of Plastic Surgery, University of Virginia, Charlottesville, Virginia
,
Kenneth Bilchick 
2   Department of Internal Medicine, University of Virginia, Charlottesville, Virginia
,
Chris A. Campbell 
1   Department of Plastic Surgery, University of Virginia, Charlottesville, Virginia
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Abstract

Breast implants whether used for cosmetic or reconstructive purposes can be placed in pockets either above or below the pectoralis major muscle, depending on clinical circumstances such as subcutaneous tissue volume, history of radiation, and patient preference. Likewise, cardiac implantable electronic devices (CIEDs) can be placed above or below the pectoralis major muscle. When a patient has both devices, knowledge of the pocket location is important for procedural planning and for durability of device placement and performance. Here, we report a patient who previously failed subcutaneous CIED placement due to incision manipulation with prior threatened device exposure requiring plane change to subpectoral pocket. Her course was complicated by submuscular migration of the CIED into her breast implant periprosthetic pocket. With subcutaneous plane change being inadvisable due to patient noncompliance, soft tissue support of subpectoral CIED placement with an acellular biologic matrix (ABM) was performed. Similar to soft tissue support used for breast implants, submuscular CIED neo-pocket creation with ABM was performed with durable CIED device positioning confirmed at 9 months postprocedure.

Keywords

breast implant - acellular dermal matrix - cardiac device

Author Contributions

P.T. contributed significantly to the manuscript and reference retrieval. K.B. and C.A.C. performed the operation, contributed to the manuscript and provided the cardiac and plastic surgery components of the paper design respectively.


Patient Consent

Written consent was obtained from the patient for the publication of images or data related to the patient.




Publication History

Received: 08 May 2022

Accepted: 15 December 2022

Accepted Manuscript online:
19 January 2023

Article published online:
28 March 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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