Sudden deflation of the tissue expander used in two-stage breast reconstruction surgery: two cases of this rare complication

Abstract

For breast cancer patients, the goal after mastectomy is to reconstruct a cosmetically beautiful, natural-appearing breast that is symmetrical to the contralateral breast. Breast reconstruction using a tissue expander is one of the most commonly employed methods. This two-stage method involves initially placing a tissue expander, followed by its exchange for a permanent implant. It is recognized as safe and effective, and demand for this procedure is gradually increasing. However, we encountered two unusual instances of sudden deflation of tissue expanders used in two-stage breast reconstruction surgery. Both expanders were placed using a dual-plane technique beneath an acellular dermal matrix. One patient had undergone radiation therapy, while the other had not. Upon removal of the tissue expanders, they were examined for physical rupture, but no abnormalities were detected. Postoperative malfunction of tissue expanders or implants is relatively uncommon, and there have been no reports of delayed leakage without rupture of the expander. In this study, we present a rare complication involving tissue expanders and discuss potential causes and solutions.