SRS321 - Postoperative outcomes of textured <i>versus</i> smooth tissue expanders in breast reconstruction surgery: a systematic review and meta-analysis

Abstract Background The recent link between Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) with textured aesthetic implants, has prompted a shift towards higher utilization of Smooth Tissue Expanders (STEs) than Textured Tissue Expanders (TTEs). This is despite no data examining or reporting incidence of BIA-ALCL within expanders. Objective We aimed to compare Smooth and Textured Expanders evaluating the postoperative outcomes and determining their risk, evaluating implant explanation, malposition/malrotation, seroma formation, capsular contracture, infection, hematoma, flap necrosis, wound dehiscence and BIA-ALCL. Methods We performed a Systematic Review and Meta-Analysis, searching Embase, PubMed and Scopus databases for articles from 2016, when WHO recognized (BIA-ALCL) disease to December 2024 (n = 1038). Studies which reported at least one postoperative complication were included. Results Eight studies have met the inclusion criteria, resulting in a total of 4832 patients (2076 STE and 2436 TTE) who received 7454 tissue expanders (TE), at an average of 1.54 expander per patient. The mean duration of follow up until expansion was 239.91 days in STE, whereas it was 247.17 days TTE. Our meta-analysis indicated significant risk difference in postoperative malposition/malrotation outcome; P = &amp;lt; 0.001, and explanation outcome; P = 0.01. There was no further significant difference found in other postoperative complications. Conclusions STEs had 1.61 higher risk of malposition/malrotation and 1.46 higher risk of explanation as primary outcome, giving TTEs lower primary outcome. The incidence of BIA-ALCL with TTE was not detected. This data supports customizing treatment plans.