Tissue “Expanders” Improve Results of Breast Reconstruction

Women who undergo breast reconstruction following mastectomy for breast cancer express strong satisfaction with a novel surgical approach, reported a surgeon at Georgetown University Medical Center in the January 1998 issue of Plastic and Reconstructive Surgery.

In a study among 171 patients tracked over 7 years, Dr. Scott L. Spear, chief, division of plastic surgery, found that 98% of women who had immediate breast reconstruction using “tissue expanders” and anatomically shaped saline-filled breast implants were satisfied with their appearance following reconstruction. The procedure posed fewer health problems to women and was more cost-effective than immediate reconstruction with breast implants alone.

Two-Stage Breast Reconstruction

The technique involved two-stage breast reconstruction, with immediate placement of tissue expanders at the time of the mastectomy, followed by an anatomic prosthetic breast implant inserted later, after chemotherapy and radiation therapy. The approach contrasts with reconstruction methods that use tissue from another body site, thus minimizing health complications because surgery is limited to the breast area. Also, the two-step procedure has fewer irreversible consequences, less scarring, and none of the trauma related to using tissue from another part of the body.

Breast reconstructions using tissue expanders were shorter and hospital stays were reduced, on average, by 1 to 3 days because the procedures were less invasive.

“Success in breast reconstruction depends on technique, device and surgeon,” writes Spear, who is also a member of the Breast Cancer Program at the Lombardi Cancer Center. “This study tells us that the combination we used provides a promising alternative in reconstructive options for mastectomy patients.”

Spear also commented that the selection of patients for breast reconstruction depended on medical and anatomic suitability, follow-up radiation, and chemotherapy; the condition of muscle and skin for closure over devices; and the patient’s goals, energy, motivation, and lifestyle.