Technical approach and clinical outcomes of delayed two-stage tissue expander/implant breast reconstruction: a single-institution experience

Background Immediate breast reconstruction after mastectomy can be challenging in some patients for medical or oncological reasons. Delayed two-stage tissue expander/implant breast reconstruction is a reliable option for these patients. However, data regarding surgical techniques, outcomes, and complication rates are limited. This study reports our experience using the two-stage tissue expander/implant procedure for delayed breast reconstruction. Methods This retrospective study included 32 patients (34 breasts) who underwent delayed two-stage tissue expander/implant breast reconstruction at our institution from January 2018 to July 2022. We summarized the techniques used in the procedure and evaluated the 1-year postoperative outcomes and complication rates. Results The mean time from mastectomy to expander insertion was 210 +/- 25 days, and 8.2 +/- 2.3 additional expansions were required prior to the implant insertion. The mean time of tissue expansion was 187 +/- 15 days, and the mean volume of expansion was 495 +/- 31 mL. No major complications occurred that required reoperation, and the patients were highly satisfied with the surgical results. Conclusions Although delayed two-stage tissue expander/implant breast reconstruction resulted in satisfactory outcomes, consensus regarding the operative technique is still needed. Two-stage tissue expander/implant breast reconstruction is a safe and effective option for delayed breast reconstruction.