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The Impact of Expander Inflation/Deflation Status During Adjuvant Radiotherapy on the Complications of Immediate Two-Stage Breast Reconstruction

  • Original Article
  • Breast Surgery
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Abstract

Background

The question of whether expander inflation/deflation status has any bearing on surgical complications in the setting of adjuvant radiation (XRT) has not been addressed. The objective of this study is to investigate whether the inflation/deflation status of the expander at the time of XRT is associated with complications in immediate two-stage expander-implant breast reconstruction.

Methods

A retrospective review of 49 consecutive patients who underwent immediate two-stage expander-implant breast reconstruction and received post-mastectomy XRT was conducted. Full deflation of the expanders was performed in the deflation group (20 patients), while the expanders remained inflated in the inflation group at the time of XRT (29 patients). XRT-related complications of each stage of reconstructions were compared between the two groups, and multivariable regression analysis was performed to identify risk factors for XRT-related complications.

Results

Overall XRT-related complications (65.0 vs. 6.9%, p < 0.001) and reconstruction failures (35.0 vs. 6.9%, p = 0.022) of the first-stage reconstructions were significantly higher in the deflation group. The most common cause of reconstruction failure in the deflation group was failure to re-expand due to skin fibrosis and contracture. In multivariable analysis, deflation of expanders was a significant risk factor for overall complications (odds = 94.4, p = 0.001) and reconstruction failures (odds = 9.09, p = 0.022) of the first-stage reconstructions.

Conclusions

Maximal inflation without deflation before XRT can be an option to minimize XRT-related complications and reconstruction failure of the first-stage reconstructions.

Level of Evidence III

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Acknowledgement

None of the authors has a financial interest in any of the products, devices, or drugs mentioned in this manuscript.

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Author notes

  1. Goo-Hyun Mun and Jai-Kyong Pyon have contributed equally to this article.

Authors and Affiliations

  1. Department of Plastic Surgery, School of Medicine, Ewha Womans University, Seoul, South Korea

    Kyong-Je Woo

  2. Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Ilwon-ro 81, Seoul, 135-710, South Korea

    Joo-Myeong Paik, Sa Ik Bang, Goo-Hyun Mun & Jai-Kyong Pyon

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  1. Kyong-Je Woo
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Correspondence to Goo-Hyun Mun or Jai-Kyong Pyon.

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Woo, KJ., Paik, JM., Bang, S.I. et al. The Impact of Expander Inflation/Deflation Status During Adjuvant Radiotherapy on the Complications of Immediate Two-Stage Breast Reconstruction. Aesth Plast Surg 41, 551–559 (2017). https://doi.org/10.1007/s00266-017-0864-5

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