Becker Expander Versus Fixed-volume Breast Implant: A Single Surgeon Multicenter Evaluation of Becker Expander and Literary Review
Laura Paul, Brenda Frowein, Klaus Brunnert, Wolfram Malter, Philipp Wiebringhaus, Tobias Hirsch, Mathias Warm, Christian EichlerAbstract
Background
Surgical possibilities and implant options in reconstructive and corrective breast surgery have expanded considerably, making comparative outcome data essential for informed preoperative decision-making.
Objectives
This study presents and compares a single surgeon's long-term experience with Becker expander and fixed-volume implants in a large patient series, supplemented by a systematic review of the literature on postoperative and long-term complications.
Methods
Records of 183 patients (247 implants) who underwent reconstructive or corrective breast surgery using fixed-volume or Becker expander implants in a single-surgeon setting were retrospectively reviewed. Patient characteristics, risk factors, and surgical indications were analyzed within each implant group. Complications were categorized as minor or major, the latter defined as any event leading to revision surgery and implant loss. Results were compared to other large (n > 100) retrospective studies identified through a PubMed literature review.
Results
Cohorts of 90 patients with 112 Becker expander implants and 93 patients with 135 fixed-volume implants were compared. Groups did not differ significantly in patient history or risk factors. Complications were documented over a minimum follow-up of 24 months (median 5.87 years). Overall complication rates did not differ significantly between groups (31.25% vs. 32.59%, p ≥ 0.05). Major complications leading to implant loss were significantly more frequent in the Becker group (9.73% vs. 2.21%, p < 0.05), though this difference could not be reproduced in any individual subgroup.
Conclusions
Despite the higher rate of major complications, overall complication rates in both groups were lower than average rates reported in the literature. Becker expanders remain a valid alternative to fixed-volume implants in single-stage reconstruction when patient selection is made carefully and aesthetic expectations favor volume adjustability.