Successful Breast Reconstruction Despite Dislodgement of Tissue Expander Magnetic Ports

Abstract

Structural failure of breast tissue expanders (TE) has previously been reported (port dislodgement,1-3 reversal of port magnetic polarity,4 and excessive heating of the magnetic port5), but in each case the surgeon has chosen to remove the failed tissue expander, thereby interrupting the reconstructive sequence and subjecting the patient to an additional, unanticipated anesthetic event. A 46-year-old woman underwent preoperative chemotherapy, bilateral skin-sparing mastectomy, immediate reconstruction with bilateral sub-pectoral Natrelle 600 mL 133MX-14 TE (Allergan, Dublin, Ireland) in November 2014. This was followed by postoperative radiation to the left axilla and chest wall. She then developed symptoms concerning for brain metastases, and 3-Tesla magnetic resonance imaging (3T MRI) was attempted, but as the table was being advanced towards the magnet, she felt the acute onset of pain in her bilateral breasts. She was immediately withdrawn from the MRI, and the test was aborted. She reported discomfort in her chest for approximately 72 hours, although physical exam did not reveal any changes (eg, burns, deformation of breast mounds). Her neurologic symptoms resolved, and her oncologists opted to not pursue further …