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Introduction: Tissue expansion is an important reconstruction method to solve defects such as burns and giant nevi or breast reconstruction. This article aims to report the experience of the Plastic Surgery Service of the Hospital de Clínicas of the Federal University of Paraná (UFPR) with the use of expanders. Methods: This is a retrospective, descriptive, and analytical study of patients who underwent tissue expansion for reconstructive surgery at the Hospital de Clínicas da UFPR, from January 2010 to December 2016. Results: 61 patients and 80 surgeries were analyzed, including re-expansion procedures. Age ranged from 2 to 73 years (mean 31). The majority of patients were female (83.6%), aged over 40 years, undergoing breast reconstruction treatment after radical mastectomy (36%). The complications observed in these patients were: signs of infection (14.7%), suture dehiscence (3.2%), seroma (3.2%), defect in the expander (3.2%), exposure of the expander (3, 2%), necrosis (1.6%) and signs of hypoperfusion (1.6%). Patients undergoing breast reconstruction had the highest number of complications (40.1%). Reexpansion was necessary for 37.7% of patients. Conclusion: The skin expansion technique is indicated for several pathologies' treatment. The tissue expansion procedure has high complication rates. Knowing the patient's profile, the main types of complications, and the factors associated with these complications can help prevent them.

INTRODUCTION: Breast cancer has become increasingly prevalent, resulting in a greater number of patients undergoing mastectomies. Post-mastectomy immediate reconstruction is an important alternative treatment in the various stages of breast reconstruction. METHODS: A retrospective study was conducted with 34 patients who underwent mastectomy or adenomastectomy, with or without preservation of the areola-papillary complex, followed by immediate reconstruction using a permanent expander. The expander used was of the Becker type 35 and anatomically shaped, having a volume ranging from 365 to 565 ml, with the 460-ml expander being the most frequently used. RESULTS: The results were considered "highly satisfactory" by 85% of the patients. The complication rate was 17.6%; two patients had skin necrosis on the edges of the surgical wound, two patients presented scar retraction in the surgical wound, one patient presented seroma, and only one patient had expander loss because of late infection after the start of chemotherapy. Thirteen patients underwent radiotherapy, of whom 53% (n = 7) had mild radiodermatitis and 30% (n = 4) had moderate radiodermatitis without other complications. CONCLUSION: Immediate reconstruction using definitive expanders presents a good treatment option for patients who will undergo total or partial mastectomy.

INTRODUCTION: Breast expanders/implants were developed in the 1980s as a breast reconstruction alternative to pre-existing techniques. They were created to provide adequate shape and volume to the breast after one-stage surgery and they do not require replacement. To evaluate the long-term results of breast reconstruction performed with Becker expanders. METHODS: This retrospective study evaluated patients who underwent breast reconstruction with implants/expanders between 2004 and 2012. RESULTS: A total of 161 expanders were implanted. Major complications (those that led to the removal or replacement of the prosthesis) comprised 22.98% of the enrolled subjects. The expander was removed and replaced by another type of reconstruction implant in 21.74% of the cases. The main reasons for the replacement were capsular contracture (31.43%), patients' desire (31.43%), and implant failure (20%). The surgical alternatives for the replaced expanders included prosthesis (91.43%), latissimus dorsi flap (5.71%), and TRAM flap (2.86%). Only few studies have evaluated the long-term effects of Becker expanders. In this study, the replacement rate was 28.57%. The study questions the use of Becker expanders as an adequate, one-stage reconstruction technique. In spite of a high rate of optimal outcomes in the new surgical procedures (37%), its use is limited because of the high costs. The expanders are still useful for patients with comorbidities or other factors that limit the performance of other surgical procedures. CONCLUSION: The use of Becker expanders as an alternative for one-stage breast reconstruction technique is very limited. Therefore, these devices should only be used in selected cases.