title: Breast reconstruction at a district general hospital.
abstract: Breast reconstruction is normally carried out by plastic surgeons, but the advent of permanent tissue expanders places post-mastectomy reconstruction within easy reach of the general surgeon. Nineteen patients underwent breast reconstruction between 1989 and 1991 using a subpectoral silicone-based, double lumen tissue expander. Assessment of results was by: (a) patient completed questionnaire; and (b) third party evaluation of standardized photographs. The mean operating time was 58 min (40-80 min) and mean hospital stay 3 days (2-7 days). Complications included one flap necrosis and one leaking injection port. Outpatient tissue expansion required an average of seven visits (4-11) and was completed in an average of 12 months (7-19). The injection port was subsequently removed under local anaesthetic as a day case. The fully dressed appearance following reconstruction was graded good or excellent by 100% of patients and in over 80% of third-party assessments. Equivalent figures for the appearance when wearing a bra were 93% and 60% and undressed 57% and 47%, respectively. All patients recommended the procedure but 25% found inflation uncomfortable. Subpectoral tissue expansion is a safe, cosmetically acceptable method of breast reconstruction which is associated with a high level of patient satisfaction.
authors.affiliation: Breast Unit, Royal Hampshire County Hospital, Winchester, UK.
authors.forename: A A
authors.initials: AA
authors.lastname: Evans
authors.forename: V F
authors.initials: VF
authors.lastname: Straker
authors.forename: R M
authors.initials: RM
authors.lastname: Rainsbury
mesh_terms: D001940:Breast / Q000473:pathology; D001943:Breast Neoplasms / Q000473:pathology / Q000534:rehabilitation / Q000601:surgery; D004954:Esthetics; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000295:instrumentation*; D008408:Mastectomy; D011184:Postoperative Period; D019736:Prostheses and Implants; D015625:Tissue Expansion Devices