Minimizing incisional dehiscence following 2-stage prosthetic breast reconstruction in the setting of radiation therapy.

Incisional dehiscence is a potential complication following prosthetic breast reconstruction. This is exacerbated in the setting of previous radiation therapy (RT) at the time of exchange of the tissue expander to a permanent implant. A technical modification is described that has successfully minimized this adverse event. Twenty-nine patients that had tissue expanders and RT underwent exchange of the device through a laterally based incision along the inframammary fold (IMF) rather than through the existing mastectomy scar. Adverse events were noted in 2 patients and included incisional dehiscence resulting from mechanical factors in one patient and a periprosthetic infection in the other. This modification has been demonstrated to be safe and effective in reducing the incidence of incisional dehiscence in previously radiated breasts.