Development of the Inframammary Fold and Ptosis in Breast Reconstruction with Textured Tissue Expanders

Abstract

Tissue expansion has become the most important method for postmastectomy breast reconstruction. However, well-defined inframammary fold and ptosis are difficult to achieve with this technique. This study was performed to evaluate the inframammary fold and ptosis achieved in breast reconstruction using a textured tissue expander, later replaced by a textured implant. In ten postmastectomy patients, a textured tissue expander was inserted into a submuscular pocket. Every two to three weeks the volume of the expander was increased by about 30%. About three months after the last filling, the expander was removed and replaced with a permanent textured, gel-filled implant. The profile of the reconstructed breast was recorded before and after the tissue expansion, as well as before and after the change of the implant. The results showed that the inframammary fold did not move significantly upwards or downwards during the expansion period when a textured tissue expander was used. Waiting three months after the last inflation of the expander before replacing it with the permanent implant resulted in a more ptotic breast mound. Usually, however, no real ptosis was achieved, meaning that the angle between the lower part of the breast and the lower chest wall was more than 90 degrees. These findings indicate that a textured expander could help create a pronounced inframammary fold, but without ptosis. A three-month waiting period before inserting the permanent implant may improve the development of an inframammary fold.

Adipose-derived stem cells: Comparison between two methods of isolation for clinical applications

“…The potential of ASCs to self-renew and regenerate tissue has great implications in wound healing and skin restoration [24]. As reported in literature the fat grafting containing adult ASCs is a highly effective therapeutic approach for the treatment of degenerative, chronic lesions induced as late effects of oncologic radiation treatments [25], the correction of secondary contour defects after breast reconstruction [26], [27], [28], [29], [30], release of painful scar contractures [31], and treatment of burn scars [32]. ASC therapeutic effects in cranial bone, articular chondrocytes, cardiac wall regeneration, functional repair after myocardial infarction and functional improvement after stroke have all been investigated [33], [34], [35], [36], [37].…”

Weight Measurement and Volumetric Displacement of Breast Implants and Tissue Expanders

“…Depending on the surgeon's preference, the volume created by the tissue expander may exceed the final implant volume by up to 20% to 30%. 1,5,8,17,18 However, given that this study shows that the physical components provide an additional 10.4% to 19.3% of volume, the developed breast pocket could be significantly larger than anticipated if they are not accounted for. Therefore, it is crucial to take these findings into consideration when inflating the expander, and also during selection of a final implant.…”

Autologous fat transplantation for breast reconstruction: A literature review

“…However, in the immediate or late postoperative period, secondary contour defects of the reconstructed breast can develop [21], [22]. There are important landmarks in the female breast, and the creation of a well-defined inframammary fold during breast reconstruction is a fundamental element in obtaining a good aesthetic result [23]. Autologous fat transplantation represents a simple solution to restore the profile of the breast after reconstruction.…”