Hyperspasticity After Partial Neurectomy for Treatment of Myospasms Following Subpectoral Breast Reconstruction

Breast reconstruction using tissue expander is a frequently used method of reconstruction after mastectomy. We describe a rare complication of myospasms after subpectoral tissue expander reconstruction with acellular dermal matrix. The patient gradually developed disturbing pectoral muscle spasms lasting almost a year. Botulinum toxin A was undesired due to its transient effect. Selective denervation of the medial pectoral nerve branches was performed and resulted in worse spasms where the breast bounced at a rapid speed. Complete denervation of the pectoral nerves led to immediate liberation. We recommend a cranial denervation of both medial and lateral pectoral nerves to secure complete denervation leading to permanent relief of involuntary spasms where selective denervation may lead to hyperspasticity.