Outcome following removal of infected tissue expanders in breast reconstruction: a 10-year experience

Although several studies have analyzed risk factors for tissue expander removal prior to permanent implant placement in breast reconstruction, the outcome following explantation because of infection is unknown. From a prospectively maintained database covering a 10-year period, 39 such patients were identified. Twelve (30.8%) had prior radiotherapy. Nine patients (23%) underwent reexpansion, 3 (7.7%) had a latissimus dorsi flap and expander, and 1 (2.6%) received a free transverse rectus abdominis flap. Recurrent infection occurred in 1 reexpanded patient. Two patients developed late contractures. All other reconstructions were successful. Twenty-six patients (66.7%) did not undergo secondary reconstruction, most commonly due to a combination of patient preference, cancer progression, and radiotherapy. After removal of an infected expander, most patients who are interested and remain good candidates can still be reconstructed. Reexpansion was successful in patients without prior radiotherapy. Secondary reconstruction with autologous tissue is appropriate when there is a history of radiotherapy.