title: Delayed two-stage breast reconstruction with implants: The authors' recent experience.
abstract: BACKGROUND
  Presently, breast cancer detection is delayed in Poland and, thus, the only other option for patients is amputation and breast reconstruction (immediate or delayed). Reconstructive methods are based on using the patient's own tissue (pedicled or free myocutaneous flaps) or implants (a tissue expander, which is later exchanged for a prosthesis or an expandable implant).
  
  
  OBJECTIVE
  To evaluate the aesthetic results of a delayed two-stage breast reconstruction with the use of implants (expander and prosthesis) in patients who have previously undergone cancer-related mastectomy.
  
  
  METHODS
  From 2006 to 2009, 54 patients (34 to 65 years of age) underwent reconstruction at least one year after their mastectomy and adjuvant chemotherapy; three women also received x-ray therapy. All women underwent a two-stage treatment with a tissue expander, which was later exchanged for a prosthesis.
  
  
  RESULTS
  Outcomes of the surgery (evaluated by the physician and the patient at least six months after all stages of reconstruction) were found to be very good in 42 patients and good in 12 patients. After amputation and x-ray therapy in two cases, a fistula developed, which necessitated implant removal.
  
  
  CONCLUSIONS
  After amputation, breast reconstruction with implants (expander and prosthesis) provides good aesthetic results. The method is mildly burdening to the patient and does not cause severe scarring. Symmetrization of the second breast is often recommended; however, the cost is not covered by the national health system. In principle, earlier x-ray therapy disqualifies the application of implants. Dividing reconstruction into two stages (expander and prosthesis) allows for possible correction of prosthesis placement.
authors.affiliation: Plastic, Reconstructive and Aesthetic Surgery Department, Medical University of Lodz, Poland.
authors.forename: Jan
authors.initials: J
authors.lastname: Rykała
authors.forename: Paweł
authors.initials: P
authors.lastname: Szychta
authors.forename: Julia
authors.initials: J
authors.lastname: Kruk-Jeromin