Mondor's disease and aesthetic breast surgery: report of case secondary to mastopexy with augmentation

Mondor's Disease after Aesthetic Breast Surgery: A Case Series and Literature Review

Background:

Mondor’s disease of the subcutaneous veins of the breast is an uncommon disorder. The etiology of Mondor’s disease remains unclear. Usually, it is a self-limited disease. This condition has been associated with trauma, surgical biopsies, breast surgery (including silicone breast implant), physical activity, and a manifestation of breast cancer.

Materials and Methods:

This is a retrospective analysis of 652 female patients who underwent aesthetic breast surgery in the last 10 years.

Results:

We found three cases of Mondor’s disease after plastic surgery of the breast (0.46%) and performed an analysis of the clinical aspects and therapeutic measures. The disease onset was a couple of weeks to 2 years after surgery, never within the first 2 weeks after surgery. We did not observe ulceration or breast cancer. Treatment was unnecessary in two patients, whereas hot compresses and nonsteroidal medical drugs were prescribed in one patient. All lesions healed within 2–3 weeks.

Conclusion:

Mondor’s disease is a possible complication after aesthetic breast surgery but often runs a self-limiting course with spontaneous remission. It is important to exclude breast cancer. The patient should be informed that the disease runs a benign and self-limiting course.

Mondor's subcutaneous banding after transaxillary breast augmentation: case report and the review of literature

Mondor's disease is a rare benign condition characterized by the formation of subcutaneous bands or strings in various locations, generally assumed to be symptoms of thrombophlebitis or phlebitis of the subcutaneous veins. Some findings, however, point toward a lymphatic origin of the bands. More biopsies of the cord and histologic studies are necessary to resolve this dispute. The chest, abdominal wall, penis, upper inner arm, and other regions of the body can be affected. The pathophysiology is unclear, but trauma of some kind, such as transsection during surgery or external compression, probably triggers its development. Mondor's thrombophlebitis occurs in 12 % of breast cancer patients. Typically, there is an abrupt onset of tenderness and pain in the affected area a few weeks or months after breast surgery. The disease course is self-limiting, lasting weeks or, on rare occasions, months before spontaneously resolving. Usually, no treatment is necessary, but sometimes a topical nonsteroid antiinflammatory ointment is given. The majority of reports describe thrombophlebitis on the thoracoabdominal wall as a sequela of breast surgery. Mondor's bowstring cord on the upper inner arm after previous transaxillary breast augmentation is rarely reported in the literature and less known. This report is intended to update our knowledge on this possible complication, which may cause unnecessary distress to the patient and the treating physician.

LEVEL OF EVIDENCE V

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Superficial thrombophlebitis (Mondor's Disease) after breast augmentation surgery

Although the aetiology of Mondor's disease remains unclear, the most commonly cited cause is trauma of some sort. Although surgical trauma has frequently been quoted, reports that specifically implicate aesthetic breast surgery are unusual in the literature. In this article, the authors report a case of superficial thrombophlebitis of the anterolateral chest wall secondary to breast augmentation surgery in a woman, five months after the procedure. The authors performed an analysis of the disease's main etiologic components and preponderant clinical aspects, and determined all appropriate therapeutic measures.

Mondor's syndrome: a clinical finding on subfascial breast augmentation

Mondor's syndrome is a clinical finding that can present in young to middle-age women 7-14 days after subfascial breast augmentation. Three cases of women who presented Mondor's syndrome after subfascial breast augmentation are reported. The cases were characterized by a tender and painful cord that originates on the middle clavicle line from the inframammary border to the umbilicus scar on the thoracoabdominal wall.

[Mondor's disease and breast plastic surgery]

AIM

Mondor's disease is a rare complication following breast plastic surgery.

CASE REPORT

We report the case of a 40-year-old woman with breast shape and volume asymmetry. She was treated by left breast submuscular prothesis augmentation followed by right breast mastopexy 6 months later. Following this surgery, she presented with subcutaneous painful abdominal cords on the right side or Mondor's disease.

DISCUSSION

We discuss the diagnosis, physiopathology and treatment of this disease in the light of scientific literature. The physiopathology is based on fascial origin in a context of local vascularitis.

CONCLUSION

Mondor's disease is a rare but benign pathology following breast plastic surgery. The treatment is symptomatic and the surgeon must reassure the patient on the benignity and the lack of consequence on the final cosmetic result.

Imperfections de résultats des implants mammaires

The non-perfect results of breast implants (i.e. preexisting asymmetries, skin wrinkling, implant displacement, anatomical implant rotation), sometimes temporary in nature, can induce some aesthetic doubts into the patients that might have implications for the patient-plastic surgeon relationship. Preexisting asymmetries (i.e. chest wall, nipple-areola complex and breast mound) considerably influence the final aesthetic result of breast augmentation. Thus, such asymmetries along with their related, even more pronounced, potential postoperative ones should be discussed with patients during the preoperative period. Skin wrinkling is closely related with filler material and implant texture. We believe that the recent, cohesive silicone gel-filled implants, which are of rough texture, might be associated with fewer incidences of skin wrinkling than other implants. Implant displacement, either upwards or downwards, could occur even many years after the operation. Capsular contracture, initial malposition and/or erroneous incision are the main causes of displacement. Anatomical implant rotation seems to be related to the mechanical and geometric features of the implant and to a reduction in adhesion factors. In these cases, implants should be replaced. We must understand that some properties of the implants are not well-known as is also the case of the implant long-run comportment inside the human body. These facts are probably responsible for the appearance of non-perfect, undesirable results. Plastic surgeons should be aware of such "inconveniences" and advise their patients.

La maladie de Mondor : une complication de la chirurgie mammaire

Mondor's disease is a rare but not uncommon complication of breast surgery. This problem is commonly described as the thrombophlebitis of the superficial thoracoabdominal veins. Symptoms combine painful contracture occurring in the sub-mammary region and/or in the axillary region, rising during arm abduction. The contracture located in the axillary region usually join the epitrochlea. Based on a serie of 8 patients, the fascial hypothesis is developed. All the patients were treated by LPG and myo-fascial techiques with a complete relief of pain in 10 days.

The association of Mondor's disease with protein S deficiency: case report and review of literature

The authors present a case of superficial thrombophlebitis of the left anterolateral chest wall in a man whose diagnostic investigation culminated in the characterization of the vasculopathy denominated as Mondor's disease associated with protein S deficiency. We performed an analysis of the disease's main etiologic components and preponderant clinical aspects and determined all appropriate therapeutic measures for the pathology at issue.

Mondor's disease

BACKGROUND

Mondor's disease is a rare entity characterized by thrombophlebitis of the subcutaneous veins of the anterolateral thoraco-abdominal wall. The most common clinical manifestations are a painful subcutaneous cord, sensation of tension, and skin retraction. This condition is usually a benign and self-limited process, although it has been associated with breast cancer.

METHODS

We describe four new cases, two men and two women, and comment on the clinical signs and possible etiopathogenic features. General physical examination, radiologic and ecographic studies, laboratory analysis including tumor markers, and exhaustive coagulation study were carried out on all patients.

RESULTS

No cases were associated with malignant disease and/or hypercoagulability stage. With conservative treatment, the evolution proved favorable in all patients.

CONCLUSIONS

Mondor's disease is usually a benign and self-limited process, but we recommend laboratory studies and physical examination, including mammography in women, in order to rule out the presence of systemic disorders, especially breast cancer.