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

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.