Smooth operator

Catic, Armin; Weinzierl, Andrea; Heimer, Jakob; Pompei, Barbara; Harder, Yves

doi:10.3390/jcm13195803

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Journal article

Smooth operator : nanotextured breast tissue expanders are associated with lower rates of capsular contracture

Catic, Armin ORCID Department of Plastic, Reconstructive and Aesthetic Surgery, Ospedale Regionale di Lugano, Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland - Faculty of Biomedical Sciences, Università della Svizzera italiana, Switzerland
Weinzierl, Andrea Department of Plastic and Hand Surgery, University Hospital Zurich, Switzerland
Heimer, Jakob Department of Mathematics, Seminar for Statistics, ETH Zurich, Switzerland
Pompei, Barbara Faculty of Biomedical Sciences, Università della Svizzera italiana, Switzerland
Harder, Yves Department of Plastic, Reconstructive and Aesthetic Surgery and Hand Surgery, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland - Faculty of Biology and Medicine, University of Lausanne (UNIL), Switzerland

2024

Published in:

Journal of Clinical Medicine. - 2024, vol. 13, no. 19, p. 5803

English ntroduced a focus on surface texturizations and a shift towards smooth breast devices, yet outcomes comparing the complication profiles of differently textured tissue expanders (TEs) remain conflicting. The study aim was to compare the complication profile of a new nanotextured and MRI-compatible TE to micro- and macrotextured TEs and to identify possible predictors for complications. Methods: A retrospective analysis of women undergoing expander-based breast reconstruction after mastectomy between January 2016 and March 2022 was conducted. The primary endpoint was the development of capsular contracture. Possible predictors were analyzed in a mixed-effects model using the least absolute shrinkage and selection operator (LASSO). Moreover, a comparison of complications and an evaluation of predictors were carried out. Results: A total of 147 breasts, encompassing 82 nanotextured, 43 microtextured and 22 macrotextured TEs, were analyzed. Breasts with nanotextured TEs were less likely to develop capsular contracture overall (OR, 0.12; 95%CI 0.05–0.28, p < 0.001). Post-mastectomy radiotherapy (PMRT) was identified as a predictor for capsular contracture (OR, 4.67; 95%CI 1.86–11.71, p < 0.001). Breasts with nanotextured TEs showed a higher rate of seroma, but lower rates of malposition and pain. Predictors for developing postoperative complications included higher mastectomy weight (p = 0.008). Conclusions: Breasts with nanotextured TEs exhibited the lowest rate of capsular contracture compared to micro- and macrotextured TEs. Together with its MRI-compatibility and improved oncologic follow-up, the nanotextured TE seems to be a favorable device for expander-based breast reconstruction.

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