Inmediate breast reconstruction with anatomical expanders: an approach feasible to obtain good results

Abstract

There is evidence on the benefits of immediate breast reconstruction following a mastectomy. Objective: The aim of this study is to evaluate our experience with anatomical expanders in immediate breast reconstruction. Methods: This study included 60 consecutive patients from CECLINES´ database in Caracas, Venezuela (2009-2013), in which an immediate breast reconstruction with anatomical expander (IBRAE) was performed. Anthropometric and surgical data was prospectively collected.
Cosmetic evaluation consisted of a five-point scale, recorded during follow-up. Analog numerical scale (ENA) established thetructions for IBRAE were: The need for radiotherapy (RT), the need for an implant> 300cc for a reconstruction of one stage and if a thin major pectoral muscle that does not allow making full muscle coverage for an implant-based reconstruction. Results: The mean age of patients was 48.5 years (SD 10.5). The average follow-up was 23.5 months (11-60). The average tumor size was 40 mm (SD 22). In 33.3% (20/60) of patients a nipple-sparing mastectomy was performed with a nipple-areola complex necrosis of 5% (1/20). The average body mass index (BMI) was 26.3 kg / m² (SD 4.5). The 90% of cosmetic scores were 4-5 (good-excellent), with a participation rate of 73% (44/60). In the rating collected by the ENA 39% of the patients had no pain and 10% had high-intensity pain or intolerable. The overall complication rate was 20% (12/60). The most frequent complications were:
capsular contracture to 5%, infection 6.6% and 3.3% hematoma. A BMI> 30 kg / m2 was associated with greater likelihood for complications