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 reconstruction failure. We analyzed outcomes after first-stage alloplastic breast reconstruction in patients receiving dual-port tissue expanders in comparison to those of patients receiving traditional, single-port devices. Methods: We retrospectively reviewed patients who underwent tissue expander placement from 2020 to 2021. A propensity-matched analysis was performed to compare the incidence of reconstruction failure in dual- and single-port expanders. Secondary outcomes included rates of seroma, hematoma, skin necrosis, wound dehiscence, surgical site infection, and patient-reported outcome measures. Results: After propensity matching, the dual- and single-port cohorts each INCLUDED 190 breasts. There was no difference in reconstruction 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: Reconstruction failure rates did not differ when using single- or dual-port tissue expanders. Increased incidence of surgical site infections in dual-port expanders, possibly attributable to increased detection, and increased rate of salvage of the infected expanders were observed.