Periimplant breast gas at high altitudes: Prevalence, significance, and possible associated factors

Abstract

OBJECTIVE. The objective of our study was to confirm the suspected incidental nature of periimplant gas and characterize possible predisposing factors. MATERIALS AND METHODS. Three hundred twenty-one chest CT examinations of patients with breast implants over a 2-year period were identified using a research database query. Scans were evaluated for the qualitative presence of gas, the implant type, and the presence of implant rupture, capsular calcifications, and axillary clips. Subjects' self-reported home state address was included as a surrogate for recent airline travel or travel from lower altitudes to our center located in Denver, CO, which is 1 mile (1.6 km) above sea level. RESULTS. Of the 321 study subjects, 55 (17.1%) had periimplant gas present. No subject had CT signs or clinical evidence of chest wall infection. Periimplant breast gas was significantly associated with residence outside Colorado (odds ratio [OR], 28.32; 95% CI, 10.60- 75.70), silicone implant type (OR, 14.56; 95% CI, 5.61-37.81), and implant rupture (OR, 4.21; 95% CI, 1.74-10.18). Capsular calcifications were associated with gas in backward elimination analysis only (OR, 2.15; 95% CI, 1.03-4.50). No association was found between periimplant gas and implant location, patient age, or the presence of axillary clips. CONCLUSION. Periimplant breast gas was relatively common in our patient population, and no association with infection was found. Our results suggest that the development of gas is related to atmospheric pressure, implant filler, and implant integrity. Gas around breast implants after airline travel or an altitude change can be safely dismissed in the absence of other associated findings.