Skin Necrosis After Methylene Blue Dye Use in Immediate Breast Reconstruction

Skin-sparing mastectomy or nipple-sparing mastectomy is usually combined with sentinel lymph node biopsy and often followed by immediate breast reconstruction. Currently, methylene blue dye (MBD) is being used for the localization of the sentinel lymph node during mastectomy in patients with early breast cancer. However, MBD has been associated with skin complications. Two patients underwent a nipple-sparing mastectomy followed by immediate reconstruction with silicone implants. MBD was injected into the subareolar area to identify the sentinel lymph node. The 2 cases were complicated by MBD. The first case developed 2 gangrenous areas on the site of the MBD injection. The second one developed skin necrosis as well. The use of MBD is responsible for skin complications, such as skin necrosis. In detail, discussion before surgery must be done when organizing immediate breast reconstruction using silicone implants.