Breast reconstruction with Becker expanders: an analysis of 116 cases

ABSTRACT

Introduction:

Breast expanders/implants were developed in the 1980s as a breast reconstruction alternative to pre-existing techniques. They were created to provide adequate shape and volume to the breast after one-stage surgery and they do not require replacement. To evaluate the long-term results of breast reconstruction performed with Becker expanders.

Methods:

This retrospective study evaluated patients who underwent breast reconstruction with implants/expanders between 2004 and 2012.

Results:

A total of 161 expanders were implanted. Major complications (those that led to the removal or replacement of the prosthesis) comprised 22.98% of the enrolled subjects. The expander was removed and replaced by another type of reconstruction implant in 21.74% of the cases. The main reasons for the replacement were capsular contracture (31.43%), patients’ desire (31.43%), and implant failure (20%). The surgical alternatives for the replaced expanders included prosthesis (91.43%), latissimus dorsi flap (5.71%), and TRAM flap (2.86%). Only few studies have evaluated the long-term effects of Becker expanders. In this study, the replacement rate was 28.57%. The study questions the use of Becker expanders as an adequate, onestage reconstruction technique. In spite of a high rate of optimal outcomes in the new surgical procedures (37%), its use is limited because of the high costs. The expanders are still useful for patients with comorbidities or other factors that limit the performance of other surgical procedures.

Conclusion:

The use of Becker expanders as an alternative for one-stage breast reconstruction technique is very limited. Therefore, these devices should only be used in selected cases.

Keywords:
Mammoplasty; Mammoplasty/adverse effects; Breast neoplasms; Prostheses and implants; Devices for tissue expansion.