Breast reconstruction using a tissue expander after enucleation of a giant fibroadenoma: A case report

Abstract Implant-based reconstruction is the most common form of breast reconstruction following mastectomy. It is most often performed in 2 stages using saline-based tissue expanders, which are then exchanged for permanent implants. Serial expansions are performed by accessing a port in the office, an inconvenient and sometimes painful process. A carbon dioxide tissue expander is a device that provides a needle-free, patient-controlled expansion utilizing a remote-controlled CO2 canister. While a patient-controlled expansion offers convenience, given that the CO2 reservoir holds approximately 1500 mL of gas, the potential for malfunction resulting in an uncontrolled expansion in unique to this device. The authors present a case report of a patient with bilateral pre-pectoral tissue expanders who underwent magnetic resonance imaging, resulting in uncontrolled expansion. Level of Evidence: 5

Download Full-text

Rib cage deformity during two-stage tissue expander breast reconstruction in patient with previous radiotherapy: a case report

Slovenian Medical Journal ◽

10.6016/zdravvestn.1315 ◽

2016 ◽

Vol 85 (1) ◽

Author(s):

Aleš Porčnik ◽

Uroš Ahčan

Keyword(s):

Case Report ◽

Breast Reconstruction ◽

Chest Wall ◽

Tissue Expander ◽

Rib Fracture ◽

Two Stage ◽

Rib Cage ◽

Radiologic Evaluation ◽

History Of ◽

Previous Irradiation

Patients undergoing two-stage breast reconstruction with tissue expander and a history of previous irradiation are predisposed to a various chest-wall deformations more than non-irradiated patients. If chest-wall depression with/without rib fracture is found intra-operatively, bigger implant should be used, with a subsequent radiologic evaluation. In the future, the development of a new, modified expander with a harder base could minimise such complications.

Download Full-text

Clinical significance of internal mammary lymph node incidentally detected during free-flap breast reconstruction: Case report and systematic review of the literature

Current Problems in Cancer: Case Reports ◽

10.1016/j.cpccr.2021.100078 ◽

2021 ◽

Vol 4 ◽

pp. 100078

Author(s):

Nhu Hanh To ◽

Barbara Hersant ◽

Inès Chaffai ◽

Sarah Kalsoum ◽

Vincent Gautheron ◽

...

Keyword(s):

Systematic Review ◽

Case Report ◽

Lymph Node ◽

Breast Reconstruction ◽

Clinical Significance ◽

Free Flap ◽

Review Of The Literature ◽

Internal Mammary Lymph Node ◽

Internal Mammary

Download Full-text

Long-term outcomes of two-stage, immediate and delayed breast reconstruction with polyurethane-covered versus textured implants: protocol of a prospective, multicentre randomised controlled trial (TIPI trial)

BMJ Open ◽

10.1136/bmjopen-2020-044219 ◽

2021 ◽

Vol 11 (5) ◽

pp. e044219

Author(s):

J X Harmeling ◽

Kevin Peter Cinca ◽

Eleni-Rosalina Andrinopoulou ◽

Eveline M L Corten ◽

M A Mureau

Keyword(s):

Randomised Controlled Trial ◽

Breast Reconstruction ◽

Controlled Trial ◽

Capsular Contracture ◽

Tissue Expander ◽

Complication Rates ◽

Two Stage ◽

Randomised Controlled

IntroductionTwo-stage implant-based breast reconstruction is the most commonly performed postmastectomy reconstructive technique. During the first stage, a tissue expander creates a sufficiently large pocket for the definite breast implant placed in the second stage. Capsular contracture is a common long-term complication associated with implant-based breast reconstruction, causing functional complaints and often requiring reoperation. The exact aetiology is still unknown, but a relationship between the outer surface of the implant and the probability of developing capsular contracture has been suggested. The purpose of this study is to determine whether polyurethane-covered implants result in a different capsular contracture rate than textured implants.Methods and analysisThe Textured Implants versus Polyurethane-covered Implants (TIPI) trial is a multicentre randomised controlled trial with a 1:1 allocation rate and a follow-up of 10 years. A total of 321 breasts of female adults undergoing a two-stage breast reconstruction will be enrolled. The primary outcome is capsular contracture at 10-year follow-up which is graded with the modified Baker classification. It is analysed with survival analysis using a frailty model for clustered interval-censored data, with both an intention-to-treat and per-protocol approach. Secondary outcomes are other complication rates, surgical revision rate, patient satisfaction and quality of life and user-friendliness. Outcomes are measured 2 weeks, 6 months, 1, 2, 3, 5 and 10 years postoperatively. Interim analysis is performed when 1-year, 3-year and 5-year follow-up is completed.Ethics and disseminationThe trial has been reviewed and approved by the Medical Research Ethics Committee of the Erasmus MC, University Medical Centre Rotterdam (MEC-2018-126) and locally by each participating centre. Written informed consent will be obtained from each study participant. The results will be disseminated by publication in peer-reviewed journals.Trial registrationNTR7265.

Download Full-text