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Spontaneous Tissue Expander Migration in an Irradiated Field: A Case Report
Lucie Bandelac1, Kaanan D Shah1, Susan Chung2
1St. George's University School of Medicine, St. George, Grenada.
Plastic and Reconstructive Surgery. Global Open
|December 22, 2021
Summary
A rare case of spontaneous tissue expander migration occurred on the irradiated side in a breast cancer patient. This highlights the importance of considering radiation-induced fibrosis when creating surgical pockets for tissue expanders.
Area of Science:
- Plastic Surgery
- Oncology
- Reconstructive Surgery
Background:
- A 59-year-old woman with a history of bilateral breast cancer underwent bilateral mastectomy and latissimus dorsi flap reconstruction with tissue expanders.
- The patient developed spontaneous unilateral tissue expander migration on the side that had been irradiated, prior to tissue expansion.
Observation:
- During surgery to reposition the migrated tissue expander, it was found in the dorsal region with a seroma.
- The surgical pocket on the chest had collapsed, and a subcutaneous tunnel indicated the migration path.
Findings:
- This is the first reported case of spontaneous tissue expander dislodgement to the donor site.
- Migration occurred exclusively on the irradiated side, despite bilateral reconstructive procedures.
Implications:
- Radiation-induced fibrosis can lead to constricted surgical pockets, increasing the risk of tissue expander migration.
- Surgeons must carefully consider the effects of prior radiation therapy on tissue elasticity and pocket integrity during reconstructive surgery.
