Correction of malrotation in two-stage breast reconstruction: outcomes and risk-factor analysis
DOI:
https://doi.org/10.1080/2000656X.2020.1817752Abstract
Abstract Although an anatomical implant is no longer recommended in practice, frequent use of the implants in the past decade left apprehension to surgeons, and malrotation is one of the concerns. However, a limited amount of literature has focused on malrotation to date, especially in breast reconstruction, and there also exists a lack of consensus regarding the correction of malrotation. Given that implant-based reconstruction has increased in frequency and there remain many potential patients who have used earlier models of anatomical implants, this study sought to analyze predisposing risk factors and approaches to correct implant malrotation. A total of 132 implants in 118 patients who underwent expander/implant reconstruction were identified and retrospectively reviewed. Seventeen (12.9%) implants showed malrotation. The results of multivariate logistic regression revealed that tissue expander malrotation in the first stage and capsular contracture were significant risk factors associated with malrotation in two-stage implant-based breast reconstruction (both p < 0.001). When a patient presents with malrotation, it is recommended that the implant be changed to a round type if a patient has multiple risk factors because malrotation tends to recur after correction. Also, even when using a round implant during two-stage breast reconstruction, additional care should be adopted for those who experienced rotation after expander insertion.Downloads
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Acta Chirurgica Scandinavica Society owns the copyright for all material published until Volume 57 (2023) unless otherwise specified. As from Volume 59 (2024) all published articles, unless otherwise specified, are published under CC-BY licences, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, with the condition of proper attribution to the original work.