Pneumothorax as a complication of augmentation mammaplasty has rarely been reported in the literature. In this article, we describe a case of bilateral iatrogenic pneumothoraces following aesthetic breast augmentation surgery in a thin patient who was a heavy smoker. Symptoms appeared progressively on the second postoperative day. Clinical examination showed abnormal pulmonary ventilation of both thoracic bases. Bilateral pneumothoraces were demonstrated by radiography and confirmed by computed tomography. The patient improved after surgical placement of 2 chest tubes, which were removed after 6 days. The authors suggest that a patient be informed of the risk of iatrogenic pneumothorax before undergoing aesthetic augmentation mammaplasty, and recommend extreme caution when injecting local anesthetic, particularly in the submuscular pocket of a very thin patient. Copyright © 2005 by The American Society for Aesthetic Plastic Surgery, Inc.
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