Original ArticleOutcome Following Removal of Infected Tissue Expanders in Breast Reconstruction A 10-Year ExperienceHalvorson, Eric G. MD; Disa, Joseph J. MD; Mehrara, Babak J. MD; Burkey, Brooke A. MD; Pusic, Andrea L. MD; Cordeiro, Peter G. MDAuthor Information From the Plastic and Reconstructive Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY. Received September 14, 2006, and accepted for publication, after revision, October 16, 2006. Financial Disclosure: The authors report no financial affiliations with Inamed or Mentor, whose devices were used in the patients included in this study. No funds were received in the preparation of this manuscript, and the type of implant used was not noted during chart review. Reprints: Peter G. Cordeiro, MD, Chief, Plastic and Reconstructive Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10021. E-mail: [email protected]. Annals of Plastic Surgery: August 2007 - Volume 59 - Issue 2 - p 131-136 doi: 10.1097/01.sap.0000252716.73356.68 Buy Metrics AbstractIn Brief Although several studies have analyzed risk factors for tissue expander removal prior to permanent implant placement in breast reconstruction, the outcome following explantation because of infection is unknown. From a prospectively maintained database covering a 10-year period, 39 such patients were identified. Twelve (30.8%) had prior radiotherapy. Nine patients (23%) underwent reexpansion, 3 (7.7%) had a latissimus dorsi flap and expander, and 1 (2.6%) received a free transverse rectus abdominis flap. Recurrent infection occurred in 1 reexpanded patient. Two patients developed late contractures. All other reconstructions were successful. Twenty-six patients (66.7%) did not undergo secondary reconstruction, most commonly due to a combination of patient preference, cancer progression, and radiotherapy. After removal of an infected expander, most patients who are interested and remain good candidates can still be reconstructed. Reexpansion was successful in patients without prior radiotherapy. Secondary reconstruction with autologous tissue is appropriate when there is a history of radiotherapy. Of 39 tissue-expander breast reconstructions requiring premature removal of the expander for infection, 31% had undergone prior radiation. Although 67% did not undergo secondary reconstruction, those who were unirradiated were able to elect to repeat the procedure. © 2007 Lippincott Williams & Wilkins, Inc.