The Effects of the COVID-19 Mask Mandate on Complication Rates in Postmastectomy Tissue Expansion

Tissue expansion is a commonly used breast reconstructive strategy. Although the procedure is regarded as safe, tissue expander to implant-based breast reconstruction is reported to have the highest rates of postoperative infection among plastic surgery operations. During the COVID-19 pandemic, face masks were required at all hospital facilities at our institution. The purpose of this study is to investigate the effects of COVID-19 mask mandate on in-office breast tissue expansion procedures.

An institutional review board-approved, retrospective review was completed on all patients who underwent unilateral or bilateral tissue expansion following mastectomy at a single institution in 2017 (prior to the COVID-19 mask mandate) and 2021 (following implementation of the mandate). Variables included were demographics, procedure information, and postoperative outcomes.

The analysis included 118 patients in the premandate group and 147 patients in the postmandate group. There was no difference in age, body mass index, smoking status, or diabetes mellitus between the 2 groups ( P > 0.05). More patients in the postmandate group underwent bilateral reconstruction as opposed to unilateral when compared with the premandate group (70.7% vs 55.9%, P = 0.014). There were no differences in major complication rate (26.3% vs 30.6%, P = 0.495) or minor complication rate 30.5% vs 26.5%, P = 0.495) between the pre-mask and post-mask mandate groups.

Our results demonstrated that the use of face masks did not play a significant role in complication rates relating to in-office tissue expansion procedures. It remains up to the discretion and comfortability of the provider if masks should be worn during the procedure.