Single-Stage Breast Reconstruction Using an All-In-One Adjustable Expander/Implant

Area of Science:

• Plastic Surgery
• Reconstructive Surgery
• Oncology

Background:

• Tissue expansion is a key component of breast reconstruction.
• Single-stage approaches using adjustable expander/implants are feasible.
• Acellular dermal matrix may be used in conjunction with expander/implants.

Purpose of the Study:

• To present the senior author's 12-year experience with single-stage breast reconstruction.
• To evaluate the outcomes of using combined expander/implants in breast reconstruction.
• To analyze factors influencing long-term outcomes in single-stage breast reconstruction.

Main Methods:

• Retrospective review of breast reconstruction cases using combined expander/implants.
• Data collected from 2002 to 2014 at a single institution.
• Logistic regression analysis to identify predictors of outcomes.

Main Results:

• 162 implants in 105 patients were analyzed with a mean follow-up of 81.7 months.
• Low complication rates observed: extrusion (0.62%), flap necrosis (1.2%), hematoma (1.2%), dehiscence (1.9%), seroma (2.5%), infection (4.9%), deflation (15.4%).
• Significant associations found between adjuvant radiotherapy and capsular contracture (P=0.034), tumor size and deflation (P=0.0014), and smoking history and infection (P=0.013).

Conclusions:

• 81% of breasts were successfully reconstructed in a single stage.
• Single-stage reconstruction with expander/implants is a cost-effective option, avoiding a second surgery.
• This method achieves results comparable to other alloplastic breast reconstructions.