Use of Tissue Expanders for Breast Reconstruction and Pacemakers?

I am a medical librarian trying to find the answer to a question for one of our physicians. He is asking me to find information on the use of tissue expanders for breast reconstruction in women who have pacemakers. I can't find anything in PubMed or Google. I have asked a couple of manufactures, but I don't know if they will reply. Do you know where I can get information about this? Thanks.

Doctor Answers 4

Breast tissue expanders and pacemakers information. Be careful

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

It is not common knowledge and not known by many plastic surgeons but breast tissue expanders are contraindicated in patients with pacemakers because the metal port contains a magnetic field which can interfere with the function of the pacemaker. I believe the manufacturer's call this a "rare earth magnet."

You can find this information if you go to the manufacturer's website and look for directions for use and/or product warning or safety label.

I attached the information for Allergan to a Web reference. The information for Mentor CPX3 expanders is on the Mentorwwllc web site. It took me awhile to find it and that's only because I knew what I was looking for.

Tissue expanders with a remote port away from the expander chamber may be okay. I hope this helps.

Nashville Plastic Surgeon
5.0 out of 5 stars 221 reviews

Pacemaker and tissue expanders

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Usually with a pacemaker, the main issue is in the operating room and using the bovie cautery.  Often the pacemeaker is shut off by the cardiogist and the patient is paced in the operating room in a different way. I do not know of any problems specifically once the expander is in and needs to be expanded.   It can impact the expander when using the magnet so it might be better to use a different device.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Pacemaker and expander

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

To the best of my knowledge, there is no contraindication.  My concern is more the reason for the pacemaker and to make sure this is done in the appropriate setting with anesthesia having seen the patient well in advance and a cardiology clearance as well.  Usually the expanders are much lower than the pacemaker and should not cause a mechanical problem.

You might also like...

Pace maker and surgery

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

That is a question to the cardiologist and what is the condition the necessetated the pacemaker. In some conditions the rep. for the pacemaker company will be present before surgery is started and they can stop the pace maker, then reactivate it at the end of surgery.

The other possibility is not use electrocautery (which interferes with the pacemaker), and use Bipolar elecrocautery.

Or use the harmonic scalpel instead of electrocautery. Depending on the device pacemaker or pace amaker defibrilator. One must ask the company that made the devise.

Surgery should be coordinated with the cardiologist so the cardiologist be available.

Surgery should be done in a hospital setting with atleast one day stay in the hospital.

Samir Shureih, MD
Baltimore Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.