Dual-Port and Single-Port Tissue Expanders in Postmastectomy Breast Reconstruction: a retrospective cohort study

Background Novel dual-port tissue expanders allow easy access to the periprosthetic space for seroma drainage and potentially reduce risk of infection or reconstructive failure. We analyze outcomes after first-stage alloplastic breast reconstruction in patients receiving dual-port tissue expanders in comparison to traditional, single-port devices. Methods We retrospectively reviewed patients undergoing placement of tissue expanders from 2020 to 2021. A propensity-matched analysis was performed to compare the incidence of reconstructive failure in dual- and single-port expanders. Secondary outcomes included rates of seroma, hematoma, skin necrosis, wound dehiscence, surgical site infection, and patient-reported outcomes measures. Results After propensity matching, the dual- and single-port cohorts each contained 190 breasts. There was no difference in reconstructive failure rate (17% vs 15%, p=0.48). Dual-port expanders had a significantly higher incidence of surgical site infections (20% vs 12%, p=0.04), but fewer infected dual-port expanders were explanted (58% vs 91% of infections, p=0.006). The remaining complication rates did not differ. Patient-reported pain interference was significantly higher in the dual-port cohort (59.1 vs 56, p=0.02). Conclusions Rates of reconstructive failure did not differ when utilizing single- or dual-port tissue expanders. There was an increased incidence of surgical site infections in dual-port expanders, possibly attributable to increased detection, along with an increased rate of salvage of these infected expanders.