Diagnosis and management of galactorrhea after breast augmentation.

[BACKGROUND] A known but not fully understood complication of breast augmentation is galactorrhea. To date, all publications on this subject have been case reports. The purpose of this retrospective study was to examine a large group of consecutive patients who had undergone breast augmentation and identify the incidence of galactorrhea and galactocele, and the associated preoperative and intraoperative risk factors. The authors also evaluated the treatment algorithm used.

[METHODS] A retrospective chart review was performed on patients who underwent primary breast augmentation using silicone implants in a single group practice from 2008 to 2013. Logistic regression for rare events data was applied to evaluate the risk of galactorrhea according to the variables.

[RESULTS] The study included 832 patients (1664 implants) who had undergone breast augmentation. The follow-up period ranged from 12 to 52 months (mean, 15 months). Eight patients (0.96 percent; 95 percent CI, 0.42 to 1.89) experienced galactorrhea after breast augmentation during the follow-up period. All eight patients had bilateral involvement, and three (0.36 percent of the total and 38 percent of the galactorrhea cases) presented with a galactocele. Use of a periareolar incision, however, statistically significantly increased the incidence of galactorrhea among these patients. The authors' management algorithm proved to be an effective clinical course of action.

[CONCLUSIONS] Although galactorrhea is rare after breast augmentation, it can be disfiguring and devastating for the patient. This is the first longitudinal retrospective study on the subject. Adequate treatment and patient information are essential.

[CLINICAL QUESTION/LEVEL OF EVIDENCE] Therapeutic, III.