Adjustable breast implants provide postoperative versatility

Abstract

Hilton Becker, MD, Boca Raton, FL , is a board-certified plastic surgeon and an ASAPS member. In the late 1970s and early 1980s, breast reconstruction was popularized with the introduction of the Radovan expander (Heyer-Schulte, Goleta, CA).1 The device was initially used to expand the tissue; this was followed by an operation to remove the expander and replace it with a permanent implant. Interestingly, it was noted that several patients were reluctant to have the Radovan expander replaced because they were very pleased with the results. This observation led me to explore the concept of creating an expander in which the injection dome could be removed, the expander itself thus being left in place. This versatility would allow a tissue expander to be converted to a permanent saline implant without an additional operation.2–4 Excellent results have been achieved in breast reconstruction through use of the expandable mammary prosthesis with prolonged overexpansion of the tight muscle/skin envelope.5 The original adjustable implant was actually a saline implant with an injection dome attached to the fill tube. The injection dome was buried and subsequently removed. Although valve leakage was a problem in many early cases, the valve was successfully modified, and a doublelumen gel-saline version was created so that the 2-stage Radovan procedure, in which a saline expander and a gel implant were used, could be performed in a single-stage procedure. ### Primary Breast Reconstruction Tissue tension is the main …