by Lee, Kyeong-Tae; Park, Hae Yeon; Jeon, Byung-Joon; Mun,
Goo-Hyun; Bang, Sa Ik; Pyon,expander Jai Kyong
Plastic and
Reconstructive Surgery: March 2021 -
Volume 147 - Issue 3 - p 545-555
Background:
In two-stage prosthetic breast reconstruction, two types of
tissue expanders are used for the first stage: microtextured Siltex and
macrotextured Biocell. Despite emerging concerns regarding the safety of
macrotextured prostheses, the association between the use of macrotextured
expanders and adverse outcomes remains unknown clinically. This study aimed to
evaluate potential impacts of the type of tissue expander on the long-term
outcomes of implant-based breast reconstruction.
Methods:
Patients who underwent immediate two-stage tissue
expander/implant breast reconstruction between 2014 and 2018 were evaluated and
categorized into two groups according to the expander type. Those two were
propensity score matched for baseline characteristics and compared for
complication rates after the first- and second-stage operations. The impacts of
several variables, including type of tissue expander used, on outcomes were
assessed using multivariable logistic regression analyses.
Results:
Of the 1391 cases in 1294 patients, 276 pairs (552 cases)
were successfully propensity score matched. In the first-stage operation, the
macrotextured group showed a significantly shorter drain indwelling period and
lower rate of seroma than the microtextured group. These differences retained
influences after adjusting for other variables. Incidence rates of other
complications were similar between the groups. Regarding the second-stage
operation, the use of macrotextured expanders showed a significant association,
with an increased rate of severe capsular contracture on the multivariable
analyses in cases using textured implants. Development of other complications
was not affected by the expander type.
Conclusion:
The type of tissue expander might influence the outcomes of two-stage implant-based breast reconstruction, and generally acceptable safety of both microtextured and macrotextured expanders was shown. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.
