Rupture of a Breast Tissue Expander Due to Chest Wall Exostosis: Case Report and Literature Review

Abstract

The incidence of device failure or rupture during tissue expansion is rare, and the etiology of device rupture is most commonly idiopathic; however, a multitude of potential etiologies have been reported including direct trauma, device over-expansion beyond manufacturer recommendations, capsular contracture, compressive forces during medical imaging studies, iatrogenic device damage during operative placement of the device or iatrogenic rupture during the process of filling the device. The authors report a case of device failure of the posterior wall of a tissue expander used for routine implant-based breast reconstruction that was attributed to bony exostosis of the anterior chest wall. They explore the relative incidence of bony exostosis-related and all-cause tissue expander rupture in peer-reviewed published literature. The present report illustrates the importance of evaluating the tissue quality of the periprosthetic capsule and pocket following a device failure to ensure that chest wall exostosis, a potential cause of further device failure, is not present.