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Infection is one of the most feared complications of implant-based breast reconstruction and is difficult to manage in irradiated patients. We present the first case of bilateral breast reconstruction with infected expanders salvaged by performing a reverse abdominoplasty. A 64-year-old woman with a history of locally advanced bilateral breast cancer underwent modified bilateral radical mastectomy and postmastectomy radiotherapy. We performed two-stage breast reconstruction with implants. However, the patient developed a mild infection of the expanders, which was treated with targeted oral antibiotic therapy. The response to treatment was favorable, allowing us to salvage the reconstruction with a reverse abdominoplasty. Traditionally, the management of infected breast prostheses has consisted of removal of the infected implant, a complication that forces a delay in the reconstructive process. Successful reports of salvage of infected prostheses have been described in the literature. On the other hand, we were able to salvage the reconstruction by performing a reverse abdominoplasty, which allowed us to resect the irradiated tissue and provide adequate non-irradiated soft tissue coverage for the replaced implants. Reverse abdominoplasty offers an acceptable aesthetic result with much less donor site morbidity and represents a valid alternative to other complex reconstruction techniques. • Infection is one of the most feared complications of implant-based breast reconstruction. • Implant salvage has been described as a viable alternative in selected cases. • Reverse abdominoplasty is an advancement flap created through a submammary incision to treat upper abdominal laxity. • This is the first case of reverse abdominoplasty as a salvage procedure for breast reconstruction with infected expanders. [ABSTRACT FROM AUTHOR]

Soft tissue metastases from any primary malignant tumor are considered very rare and can be found in subcutaneous or muscle tissue. We present the fifth case of breast cancer (BC) metastasis in subcutaneous tissue of the back and with an interval of 15 years between its detection and the diagnosis of BC. A 57-year-old woman with a history of left mastectomy with axillary lymphadenectomy and immediate breast reconstruction due to invasive ductal BC with positive hormone receptors and HER2 negative 15 years ago. She consulted for a mass on her back and elevated levels of CA15-3. Nuclear magnetic resonance showed a tumor in the subcutaneous tissue in contact with the muscular aponeurosis. Radical metastasectomy was performed with curative intent and intraoperative control of the margins by freezing. Histopathology and immunohistochemistry reported a lesion consistent with breast adenocarcinoma metastasis, with positive estrogen and progesterone receptors, positive GATA-3, negative HER2, and free margins. The patient is free of disease 4 years after surgery. The incidence of soft tissue metastasis of breast cancer is 0.2–0.8 %. To date, only four cases of BC metastasis in the subcutaneous tissue of the back have been reported. This is the case with the longest relapse time reported in the literature. Soft tissue metastases should be suspected in all patients with a history of breast cancer, even 15 years after diagnosis. • Breast cancer (BC) became the most common cancer globally as of 2021. • The most common sites of dissemination of BC are the bones, lungs, liver, brain, and distal lymph nodes. • Metastatic carcinomas presenting as soft tissue masses are rare and may be confused with a primary soft tissue sarcoma. • This is the fifth case of breast cancer metastasis reported in the subcutaneous tissue of the back. [ABSTRACT FROM AUTHOR]