Tissue expansion for breast reconstruction: Methods and techniques

Abstract

Objective

In this work, the authors review recent data on the different methods and techniques of TE/implant-based reconstruction to determine the complication profiles and the advantages and disadvantages of the different techniques. This information will be valuable for surgeons performing breast reconstructions.

Materials and methods

A thorough literature review was conducted by the authors concerning the current strategy of tissue expander (TE)/implant-based breast reconstruction following breast cancer surgery.

Results

Loss of the breast can strongly affect a woman's personal and social life while breast reconstruction reduces the sense of mutilation felt by women after a mastectomy, and provides psychosocial as well as aesthetic benefits. TE/implant-based reconstruction is the most common breast reconstructive strategy, constituting almost 65% of all breast reconstructions in the US. Although numerous studies have been published on various aspects of alloplastic breast reconstructions, most studies are single-center observations. No evidence-based guidelines are available as yet. Conventional TE/implant-based reconstruction can be performed as a two-stage procedure either in the immediate or delayed setting. Moreover, the adjunctive use of acellular dermal matrix further broadened the alloplastic breast reconstruction indication and also enhanced aesthetic outcomes.

Conclusions

TE/implant-based reconstruction has proved to be a safe, cost-effective, and reliable technique that can be performed in women with various comorbidities. Short operative time, fast recovery, and absence of donor site morbidity are other advantages over autologous breast reconstruction.

Highlights

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  Diagnosis of breast cancer at increasingly earlier stages has encouraged the development of more conservative mastectomy.

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  Breast reconstruction is an integral part of the management of breast cancer providing both psychosocial and aesthetic benefits.

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  Tissue expander/implant-based reconstruction constitutes almost 65% of all breast reconstructions.

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  Tissue expander/implant-based reconstruction can be performed as a two-stage procedure either in immediate setting or delayed.

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  Most studies on breast reconstructions are single-center observations and no evidence-based guidelines are available yet.