Breast Reconstruction Using Smooth, Non-Magnetic Radiofrequency Identification Port Tissue Expanders: Outcome Analysis and Risk Factors in 471 Reconstructions

BACKGROUND: Most breast reconstructions are implant-based (IBR) and performed in two stages using tissue expanders (TE). Despite widespread indication for use, conventional TE can present limitations, especially those that containing metallic or magnetic ports. A new generation of TE incorporating non-metallic radiofrequency identification (RFID-TE) systems has been introduced. OBJECTIVES: To assess outcomes/risk factors for complications following IBR with RFID-TE systems. METHODS: A retrospective cohort of patients who underwent IBR RFID-TE was identified, defining the primary endpoint as occurrence of complications/risk factors. We also evaluated the quality of magnetic resonance images (MRI;T1/T2-weighted sequences) taken for further diagnosis. RESULTS: 356 patients (mean age:49.9±9.6 years) underwent 471 IBR RFID-TE systems; average follow-up of 29.4±16.6 months; 77 patients (21.6%) experienced complications, most frequently seroma (7.8%). More complications were observed in older patients (p=0.005), smokers (p=0.009), and those who received radiotherapy (p=0.005) and reconstruction using a premuscular pocket (p=0.001). Multivariate regression found that older patients and smokers had odds ratios of 2.12 (p=0.013) and 2.30 (p=0.024), respectively, for developing complications. Radiotherapy (OR:2.29; p=0.024) was also an independent risk factor for overall complications. Use of a submuscular pocket was associated with significantly lower odds of developing seroma (OR:0.21, p=0.08). MRI demonstrated excellent quality, with no artifact-related negative impacts. CONCLUSIONS: Despite extensive research on IBR, previous studies on RFID-TE are limited and did not analyze predictive risk factors. Our findings demonstrate that RFID-TE is a reliable technique, with results similar to those for other series using different devices. The absence of significant imaging artifacts contributes to follow-up and offers benefits over traditional TE.