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Chest-wall deformity after tissue expansion for breast reconstruction
J D Sinow1, R A Halvorsen, J P Matts
1Division of Plastic and Reconstructive Surgery, University of Minnesota Medical School, Minneapolis.
Plastic and Reconstructive Surgery
|December 11, 1991
Summary
Tissue expansion for breast reconstruction commonly causes chest-wall deformity, often undetected by standard X-rays. However, this deformity typically resolves after permanent implants are placed, with minimal clinical impact.
Area of Science:
- Plastic Surgery
- Medical Imaging
- Reconstructive Surgery
Background:
- Tissue expansion is a common technique for breast reconstruction.
- Chest-wall deformity can be a potential complication of tissue expanders.
Purpose of the Study:
- To evaluate the incidence and characteristics of chest-wall deformity after breast reconstruction using tissue expansion.
- To assess the sensitivity of different imaging modalities for detecting this deformity.
- To determine the clinical significance and resolution of chest-wall deformity.
Main Methods:
- A prospective longitudinal study involving 19 women undergoing breast reconstruction with tissue expanders.
- Utilized computed tomography (CT) imaging and a semiquantitative scale to measure chest-wall deformity.
- Compared CT imaging with routine chest roentgenograms for sensitivity.
- Analyzed correlations between deformity and clinical factors, including capsular contracture and patient outcomes.
Main Results:
- CT imaging detected abnormalities in all patients (100%) and 94% of expanders.
- Rib and chest-wall contour changes were observed in 81% and 68% of expanders, respectively.
- Routine chest roentgenograms were insensitive to these deformities.
- Early capsular contracture was negatively correlated with chest-wall deformity.
- Deformity significantly decreased by 57% after permanent implant placement and capsulotomy.
Conclusions:
- Chest-wall deformity is a frequent, though usually minor, complication of tissue expansion for breast reconstruction.
- CT imaging is a sensitive tool for detecting occult chest-wall deformities.
- Surgical correction with permanent implants effectively reduces the severity of chest-wall deformity.