title: [Subcutaneous emphysema during breast augmentation: case report].
abstract: OBJECTIVE
  Subcutaneous emphysema of the thoracic wall during a surgical procedure with infiltration of local anesthetics may suggest the presence of pneumothorax and its complications. The development of pneumothorax during breast augmentation has already been reported; however, we did not find any reports in the literature on isolated subcutaneous emphysema during this type of procedure. The objective of this report was to emphasize the importance of adequate intraoperative monitoring of the patient, integration of team members, and describe the isolated subcutaneous emphysema in a patient during breast augmentation.
  
  
  METHODS
  A 27 years old patient with 1.70 m and 54 kg, with bilateral hypomasty, underwent breast augmentation in a retroglandular plane. It was done under inhalational general anesthesia associated with infiltration of an anesthetic solution in the subcutaneous tissue in the area to be manipulated. During the procedure, crepitation, characteristic of subcutaneous emphysema, was observed over a large area of the anterior thorax. There were no changes in monitoring parameters. Postoperative chest X-rays confirmed the clinical diagnosis and ruled out the presence of other complications.
  
  
  CONCLUSIONS
  Subcutaneous emphysema during breast augmentation can be an innocent sign, but it is important to evaluate the patient to rule out the presence of a pneumothorax.
authors.affiliation: Hospital Universitário Clementino Fraga Filho da UFRJ, Rio de Janeiro, Brazil.
authors.forename: Talita
authors.initials: T
authors.lastname: Franco
authors.forename: Diogo
authors.initials: D
authors.lastname: Franco
authors.forename: Natan
authors.initials: N
authors.lastname: Treiger