BREAST RECONSTRUCTION AT A DISTRICT GENERAL-HOSPITAL

Breast reconstruction is normally carried out by plastic surgeons, but the advent of permanent tissue expanders places post-mastectomy recon struction within easy reach of the general surgeon. Nineteen patients underwent breast reconstruction between 1989 and 1991 using a subpecto ral silicone-based, double lumen tissue expander. Assessment of result s was by: (a) patient completed questionnaire; and (b) third party eva luation of standardized photographs. The mean operating time was 58 mi n (40-80 min) and mean hospital stay 3 days (2-7 days). Complications included one flap necrosis and one leaking injection port. Outpatient tissue expansion required an average of seven visits (4-11) and was co mpleted in an average of 12 months (7-19). The injection port was subs equently removed under local anaesthetic as a day case. The fully dres sed appearance following reconstruction was graded good or excellent b y 100% of patients and in over 80% of third-party assessments. Equival ent figures for the appearance when wearing a bra were 93% and 60% and undressed 57% and 47%, respectively. All patients recommended the pro cedure but 25% found inflation uncomfortable. Subpectoral tissue expan sion is a safe, cosmetically acceptable method of breast reconstructio n which is associated with a high level of patient satisfaction.