Tissue expander overfilling: Achieving new dimensions of customization in breast reconstruction

Matthew D. Treiser, Tracy Lahair, Matthew J. Carty

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Introduction: Overfill of tissue expanders is a commonly used modality to achieve customized dimensions in breast reconstruction. Little formal study of the dynamics of hyperexpansion of these devices has been performed to date, however. Methods: Overfill trials were performed using both Natrelle 133 MV and Mentor 8200 tissue expanders of indicated capacities ranging from 250 to 800 mL. Each expander was initially filled to its indicated capacity with normal water and then injected in regular increments to 400% overfill. Measurements of each expander’s width, height, and projection were made at indicated capacity and with each successive incremental overfill injection, and these results were then recorded, collated, and analyzed. Results: Over the first 50% overfill, all expanders demonstrated a logarithmic increase in projection (mean increase, 143 ± 9%) while maintaining essentially stable base dimensions. Overfill levels in excess of 50% were accompanied by linear increases in height, width, and projection, during which projection approached, but never equaled, base dimensions. Stress versus strain analyses demonstrated nonlinear biomechanical dynamics during the first 50% overfill, followed by standard elastic dynamics up to 400% overfill. At no point during the study, did expander tensions outstrip elastic properties, thereby explaining the lack of device rupture. Conclusions: Through overfilling, tunable geometries of tissue expanders can be accessed that may provide for increasing customization of reconstructions, particularly at overfill volumes up to 50% over indicated capacity. This study should serve to guide tissue expander selection and fill volumes that surgeons may implement in obtaining ideal reconstructed breast shapes.

Original languageEnglish (US)
Article numbere612
JournalPlastic and Reconstructive Surgery - Global Open
Volume4
Issue number2
DOIs
StatePublished - Jan 1 2016
Externally publishedYes

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Tissue Expansion Devices
Mammaplasty
Equipment and Supplies
Mentors
Nonlinear Dynamics
Rupture
Breast
Injections
Water

ASJC Scopus subject areas

  • Surgery

Cite this

Tissue expander overfilling : Achieving new dimensions of customization in breast reconstruction. / Treiser, Matthew D.; Lahair, Tracy; Carty, Matthew J.

In: Plastic and Reconstructive Surgery - Global Open, Vol. 4, No. 2, e612, 01.01.2016.

Research output: Contribution to journalArticle

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abstract = "Introduction: Overfill of tissue expanders is a commonly used modality to achieve customized dimensions in breast reconstruction. Little formal study of the dynamics of hyperexpansion of these devices has been performed to date, however. Methods: Overfill trials were performed using both Natrelle 133 MV and Mentor 8200 tissue expanders of indicated capacities ranging from 250 to 800 mL. Each expander was initially filled to its indicated capacity with normal water and then injected in regular increments to 400{\%} overfill. Measurements of each expander’s width, height, and projection were made at indicated capacity and with each successive incremental overfill injection, and these results were then recorded, collated, and analyzed. Results: Over the first 50{\%} overfill, all expanders demonstrated a logarithmic increase in projection (mean increase, 143 ± 9{\%}) while maintaining essentially stable base dimensions. Overfill levels in excess of 50{\%} were accompanied by linear increases in height, width, and projection, during which projection approached, but never equaled, base dimensions. Stress versus strain analyses demonstrated nonlinear biomechanical dynamics during the first 50{\%} overfill, followed by standard elastic dynamics up to 400{\%} overfill. At no point during the study, did expander tensions outstrip elastic properties, thereby explaining the lack of device rupture. Conclusions: Through overfilling, tunable geometries of tissue expanders can be accessed that may provide for increasing customization of reconstructions, particularly at overfill volumes up to 50{\%} over indicated capacity. This study should serve to guide tissue expander selection and fill volumes that surgeons may implement in obtaining ideal reconstructed breast shapes.",
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