A 51-year-old lady underwent delayed two-stage right breast reconstruction following right mastectomy with radiotherapy, 2 years previously. A McGhan® 133LV 500 cc (Inamed Aesthetics, Allergan Inc, CA, USA) low height biodimensional tissue expander with integrated-valve was inserted subcutaneously with no intraoperative saline inflation. Postoperatively, after the fourth saline inflation the implant was leaking and was subsequently removed. A hole was found through the full thickness of the implant 5 mm from the edge of the lower pole. We noted that the uninflated lower pole folds over the implant back plate in such a way that the lower pole then approximates the filling port. When the empty implant is placed in situ, tucked up against the lower edge of the pocket at the level of the inframammary fold, the lower pole may overlay the lower edge of the filling port. Subsequent percutaneous expansion may therefore inadvertently catch the lower pole of the implant (Fig. 1). We would therefore advocate care when placing these uninflated devices to avoid this problem.
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Published online: June 11, 2007
© 2007 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.