Low capsular contraction rate after primary and secondary breast reconstruction with a textured expander prosthesis

The expander prosthesis has the advantage over the temporary expander of being permanent and thus does not require an operation when the implant has to be exchanged for a permanent prosthesis. Forty-nine women who had had either primary or secondary breast reconstruction performed with a permanent textured expander prosthesis were included in the study. No patient in either group had received radiotherapy. Breast softness was evaluated by an objective method, applanation tonometry, when saline was extracted from the implant to the desired breast volume after 3 months of slight overexpansion. Follow-up examinations were done 6 and 12 months later. In both groups the breasts became harder between the extraction of saline and the 6-month follow-up but then remained unchanged at the 12-month checkup. The capsular contracture rate after 6 months was 11 percent in the primary breast reconstruction group (n = 37) and 0 percent in the secondary breast reconstruction group (n = 11). After 12 months, the results were constant. There was no statistically significant difference between the two groups at any time. The low capsular contracture rate in both groups shows the suitability of the expander prosthesis for achieving good results in both primary and secondary breast reconstruction. Objective evaluation of the results in order to compare different materials and methods of breast reconstruction should be mandatory.