Chest-Wall Deformity after Tissue Expansion for Breast Reconstruction

Pre‐augmentation soft tissue expansion: an overview

“…Expansion‐mediated bone deformity might be a minor clinical finding (Sinow et al. ). Nevertheless, in some cases the bone deformations are not completely resolved after expander removal and deformities will remain (von See et al.…”

Substantial chest-wall deformity following tissue expansion after radiotherapy

“…In 1991, Sinow et al [5] published a prospective study on the subject, using computed tomography imaging and a semi-quantitative scale to measure the extent of deformity. They found some form of rib deformity in most patients, moderate or greater rib depression in 13% of their patients, and even an asymptomatic rib fracture in one patient.…”

“…Minor deformation of the chest wall is frequently seen after tissue expansion [4, 5], but the less common moderate to severe chest-wall deformity is a more serious complication, and one should take into account that it can lead to considerable morbidity [5]. It is widely known that radiotherapy is associated with a substantially higher complication rate in prosthetic breast reconstruction [7], worsened aesthetic outcome, and significantly increased capsular contraction in immediate breast reconstruction with implants [8].…”

“…Similar to the former complications, the chance of chest-wall deformation after tissue expansion is most likely increased by irradiation. Whether this is due to decreased strength of the ribs or tightening of the overlying soft tissue is unknown [5]. …”

“…A less documented complication is that of chest-wall deformity following tissue expansion. It has been described before, but predominantly in osteoporotic women [2, 3] and in patients whose expanders were significantly overinflated [4, 5]. …”