Hyperspasticity After Partial Neurectomy for Treatment of Myospasms Following Subpectoral Breast Reconstruction

Breast reconstruction using tissue expander is a frequently used method of reconstruction after mastectomy. We describe a rare complication of myospasms after subpectoral tissue expander reconstruction with acellular dermal matrix. The patient gradually developed disturbing pectoral muscle spasms la...

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Bibliographic Details
Published in:Plastic and reconstructive surgery. Global open 2019-05, Vol.7 (5), p.e2278-e2278
Main Authors: Mamsen, Frederik P., Carstensen, Lena F.
Format: Article
Language:English
Subjects:
Case Report
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Summary:Breast reconstruction using tissue expander is a frequently used method of reconstruction after mastectomy. We describe a rare complication of myospasms after subpectoral tissue expander reconstruction with acellular dermal matrix. The patient gradually developed disturbing pectoral muscle spasms lasting almost a year. Botulinum toxin A was undesired due to its transient effect. Selective denervation of the medial pectoral nerve branches was performed and resulted in worse spasms where the breast bounced at a rapid speed. Complete denervation of the pectoral nerves led to immediate liberation. We recommend a cranial denervation of both medial and lateral pectoral nerves to secure complete denervation leading to permanent relief of involuntary spasms where selective denervation may lead to hyperspasticity.
ISSN:2169-7574
2169-7574
DOI:10.1097/GOX.0000000000002278