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Plastic Surgery International
Volume 2011 (2011), Article ID 952197, 7 pages
Research Article

Tissue Expansion: Further Attempts to Improve Results in Breast Reconstruction

1Department of Plastic and Reconstructive Surgery, University of Cape Town Private Hospital and Christiaan Barnard Memorial Hospital, Academy of Plastic Surgery, 310 Library Square, Wilderness Road, Claremont, Cape Town, South Africa
2Department of Plastic Surgery, H53, O.M.B., Groote Schuur Hospital, Observatory, Cape Town 7925, South Africa

Received 15 November 2010; Revised 25 February 2011; Accepted 1 March 2011

Academic Editor: Yoshihiro Kimata

Copyright © 2011 Donald A. Hudson et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Tissue expansion, is a simple method of breast reconstruction. Method. A prospective study of 27 patients treated over a 43 month period is described. At the first stage the expander is inserted in the dual plane, and the medial pectoral nerve is divided. The tissue expander is over-expanded. Second stage: a de-epithelialized vertical triangle is used to aid anterior projection, an inframammary fold is created and a silicone gel prosthesis inserted. Z-plasties are added to the transverse scar. The contralateral breast can be treated or left alone. Complications were recorded and the results were assessed by 4 plastic surgeons using a visual analogue scale. Results. 19 patients had expanders inserted at mastectomy (2 bilateral) and 8 underwent delayed reconstruction, with a mean age of 47 years (range 30–65 years). A single prosthesis was inserted in 15 patients (mean size 320 mL) and two prosthesis were stacked in 12 patients (mean volume of 400 mL). The mean delay from full expansion to the second stage was 10 weeks (range 3 weeks–11 months). A contralateral augmentation was performed in 5 patients, pexy in 10, a reduction in 2 and in 8 patients no procedure was performed. One patient required explantation. The mean visual analogue assessment was 7. Conclusion. This technique should be considered enhance the cosmetic results in tissue expansion.