A Comparison of Permanent Expander-Implant in Immediate and Delayed Breast Reconstruction after Modified Radical Mastectomy

ABSTRACT

Breast reconstruction is considered as the best choice to improve the quality of life for the mastectomy patient. Recent trends in breast reconstruction have transitioned toward the skin-sparing type of mastectomy and immediate reconstruction using autologous tissue or expander-implant. Immediate prosthetic breast reconstruction is a relatively simple, quick procedure without donor site morbidity. Tissue expansion also has become the most important method for postmastectomy breast reconstruction. However, well-defined inframammary fold and ptosis are difficult to achieve with this technique. Improvements in implant technology have seen the evolution of shaped, fixed-volume implants and permanent expanders. The aim of the present study was to assess outcome after immediate breast reconstruction using the Sebbin permanent expander implant and delayed breast reconstruction with the same expander- implant. A total of 25 consecutive patients were studied over a 7-year period; 18 patients had immediate expander-implant placement, and 7 patients had delayed expander-implant. Postoperative photograph assessment by 20-observer and patients' telephone-questionnaire were evaluated using double blind method. Expander implants used in immediate breast reconstruction are associated with high levels of patient and surgeon satisfaction. Natural breast form can be achieved during this single operation with a low incidence of complications.