Abstract 120: Smooth Versus Textured Tissue Expanders in Breast Reconstruction Reduced Early Post-operative Complications

Tevlin, Ruth; Borrelli, Mimi R.; Azad, Amee D.; Posternak, Victoria; Wan, Derrick C.; Nguyen, Dung; Nazerali, Rahim

doi:10.1097/01.gox.0000558394.99597.d0

Cited by 1 publication

(8 citation statements)

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“…5,6,18 The textured outer shell was originally created to promote ingrowth of tissue, and the use of textured TEs became the standard in the hopes of decreasing rates of malposition, rotation, and migration of the device. 15,[19][20][21][22][23] However, after the U.S. Food and Drug Administration recall of Allergan textured devices in July of 2019, many institutions switched to using smooth devices exclusively. At our institution, before the recall, 75.4% of TEs used were textured, whereas after the recall, 99.3% were smooth.…”

Section: Discussionmentioning

confidence: 99%

“…Although studies examining implant and TE complication rates exist, 9,[11][12][13] literature comparing the complication profiles of textured versus smooth surface devices is sparse. 15,16,23 Tevlin et al retrospectively compared complication rates between 39 textured and 48 smooth TEs, and reported significantly more frequent postoperative complications in the textured cohort (P = 0.001), including significantly higher rates of seroma formation and nonsignificantly higher rates of infection and TE failure. 15 This differed from our results, which demonstrated no difference in seroma rates or TE failure.…”

Section: Discussionmentioning

confidence: 99%

“…15,16,23 Tevlin et al retrospectively compared complication rates between 39 textured and 48 smooth TEs, and reported significantly more frequent postoperative complications in the textured cohort (P = 0.001), including significantly higher rates of seroma formation and nonsignificantly higher rates of infection and TE failure. 15 This differed from our results, which demonstrated no difference in seroma rates or TE failure. In addition, although our unmatched analysis showed higher rates of infection in the overall smooth TE cohort, there was no difference in infection rates between smooth and textured TEs in the propensity-matched cohorts.…”

Section: Discussionmentioning

confidence: 99%

“…Of note, more than 70% of patients in their study underwent a nipple-sparing mastectomy. 15 The small sample size and the large proportion of nipplesparing mastectomies likely influenced the complication profiles, making the other study less generalizable and applicable.…”

Section: Discussionmentioning

confidence: 99%

“…Although complication rates of breast implants and TEs have been examined, 5,[7][8][9][10][11][12][13][14] studies comparing the complication profiles between textured and smooth devices are sparse and have small sample sizes overall. [15][16][17] The primary study aim is to compare complication rates in patients undergoing two-stage postmastectomy breast reconstruction with either textured or smooth TEs. The secondary aim is to compare smooth and textured TE complication rates within cohorts of prepectoral and subpectoral TE placement.…”

Section: Ementioning

confidence: 99%

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Textured versus Smooth Tissue Expanders: a Comparison of Complications in 3,526 Breast Reconstructions

Nelson

Rubenstein

Vorstenbosch

et al. 2023

Plastic &Amp; Reconstructive Surgery

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Background: Increased understanding of breast implant–associated anaplastic large-cell lymphoma has led to a shift away from textured breast devices. A few small studies have compared the complication rates of textured and smooth tissue expanders (TEs). The aim of this study was to compare complication profiles in patients undergoing two-stage postmastectomy breast reconstruction with either textured or smooth TEs. Methods: The authors performed a retrospective review of female patients who underwent immediate breast reconstruction with textured or smooth TEs from 2018 to 2020 at their institution. Rates of seroma, infection/cellulitis, malposition/rotation, exposure, and TE loss were analyzed in the overall cohort and subgroups undergoing prepectoral and subpectoral TE placement. A propensity score–matched analysis was used to decrease the effects of confounders comparing textured and smooth TEs. Results: The authors analyzed 3526 TEs (1456 textured and 2070 smooth). More frequent use of acellular dermal matrix, SPY angiography, and prepectoral TE placement was noted in the smooth TE cohort (P < 0.001). Univariate analysis suggested higher rates of infection/cellulitis, malposition/rotation, and exposure in smooth TEs (all P < 0.01). Rates of TE loss did not differ. After propensity matching, no differences were noted in infection or TE loss. Prepectoral smooth expanders had increased rates of malposition/rotation. Conclusions: TE surface type did not affect rates of TE loss, although increased rates of expander malposition were noted in the smooth prepectoral cohort. Further research is needed to examine breast implant–associated anaplastic large-cell lymphoma risk with temporary textured TE exposure to improve decision-making. CLINICAL QUESTION/LEVEL OF EVIDENCW: Therapeutic, III.

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