The Oldest Medical and scientific document known is the Edwin Smith Surgical Papyrus. This in thought to be an undated version of documents prepared by in around 3000 BC. Greek soldiers in the Trojan War, in the first century AD, were remove from the battle field and looked after in certain barracks or ships which seemed to be the earliest trauma centers for pneumothorax. Thoracic trauma has been the major emergency in war and cause for mortality.
Breast augmentation is one of the most common authentic surgeries performed worldwide. Most of the common complications associated with it are capsular contracture, hematoma, bruising, infection breast asymmetry, implant rotation, etc. Pneumothorax generally speaking is regarded as a rare complication. It occurs at a rate of less than 1:1.000. The literature review indicates that
It may be occurring more frequently than previously thought. Various mechanisms of its notation have been observed and hypothesized. The obvious ones are direct trauma to the pleura.
during surgery, needle penetration during local infiltration, and thermal damage from diathermy. Barotrauma during implant insertion has also been suggested as another mechanism, as' are high ventilation pressure, the presence of pleural blebs, oxygen rush when changing oxygen-cylinders, and defective pressure valve in the anesthetic circuit.
No large multicenter studies have been done that would help in revealing the true extent of the problem mainly due to the nature of plastic surgery practice. When it occurs it is most distressing for the patient and very concerning to the surgeon. The rate of litigation in relation to pneumothorax during breast augmentation is about 10%.
Doctor beware ... as we all know the anatomy is not always the same. One woman's pectoralis major can be thin, another thick, another virtually nonexistent. The pectoralis minor is often fused to the major or can have a broad origin. The insertion of the pectoralis major into the inframammary fold can vary, making it difficult to get into the submuscular plane. Digital confirmation of the ribs and direct vision of the pectoralis edge andlor serratus muscles are recommended to avoid cutting through the intercostal muscle and creating a potential for pneumothorax.