Zaluzec Rebekah M, Patel Ronak Ajay, Cohen Mimis
From the Department of Plastic and Reconstructive Surgery, College of Medicine, University of Illinois at Chicago, Chicago IL.
Ann Plast Surg. 2019 Apr;82(4):478-481. doi: 10.1097/SAP.0000000000001757.
Ventriculoperitoneal shunt (VPS) placement is a common neurosurgical procedure with a high rate of distal catheter malfunction. Rarely, the catheter may migrate to other tissues in the body including the breast pockets. There are increasing odds that a patient may undergo both breast augmentation and VPS placement, because breast augmentation is the most common aesthetic surgical procedure. Complications are possible with both surgical procedures. Proximal migration of the distal aspect of a VPS into the breast pocket containing an implant is a rare complication. We hereby present a successful management of VPS migration with implant salvage and culture-directed antibiotics using a careful no touch technique by avoiding breast incision and washout, or percutaneous drainage, and using the existing VPS as an in situ drainage access point for CSF fluid aspiration and culture.