Analysis of risks and aesthetics in a consecutive series of tissue expansion breast reconstructions

A consecutive series of 73 patients underwent tissue expansion for breast reconstruction between 1980 and 1986. The cases were reviewed, and preoperative risk factors, postoperative complications, and aesthetic results were assessed. Cigarette smoking correlated with a higher incidence of complications and unfavorable results. Similar correlations were found among patients with histories of significant medical disorders or alcohol abuse, although patient numbers were small in these categories. Subpectoral and suprapectoral placement of expanders yielded similar complication rates and aesthetic results. Surgical techniques contributing to improved aesthetic results are described.