IMMEDIATE BREAST RECONSTRUCTION IN 2 STAGES USING TEXTURED, INTEGRATED-VALVE TISSUE EXPANDERS AND BREAST IMPLANTS - A RETROSPECTIVE REVIEW OF 171 CONSECUTIVE BREAST RECONSTRUCTIONS FROM 1989 TO 1996
Sl. Spear et A. Majidian, IMMEDIATE BREAST RECONSTRUCTION IN 2 STAGES USING TEXTURED, INTEGRATED-VALVE TISSUE EXPANDERS AND BREAST IMPLANTS - A RETROSPECTIVE REVIEW OF 171 CONSECUTIVE BREAST RECONSTRUCTIONS FROM 1989 TO 1996, Plastic and reconstructive surgery, 101(1), 1998, pp. 53-63
A 7-year experience with 171 consecutive immediate breast reconstructi
ons by one surgeon using a textured integrated-valve tissue expander w
as reviewed. All patients were reconstructed in multiple stages using
a temporary biodimensional tissue expander followed months later by a
long term implant. There was one (0.6 percent) spontaneous expander de
flation that was replaced. Two (1.2 percent) expanders were removed fo
r infection, and one was removed electively. Fourteen patients (8 perc
ent) had flaps as well as expanders. Initially, expanders were replace
d with silicone gel-filled and round saline-filled implants. Later, ex
panders were replaced mostly with anatomically designed textured salin
e-filled implants. Of the 171 expanders, 139 were thus ultimately foll
owed by such anatomic designs. Seven (4 percent) of the implants were
replaced because of deflation over 7 years. Five patients were lost to
follow-up during the expansion phase of their reconstruction. Thirtee
n percent of these reconstructions received local radiation either bef
ore, during, or after expansion. There were a total of five (2.9 perce
nt) significant capsular contractures, with four of them occurring in
radiated patients. Ninety-eight percent of a subgroup of 42 consecutiv
ely queried patients expressed satisfaction with their reconstruction,
while only 2 percent of the queried patients were dissatisfied.