Direct-to-Implant Breast Surgery Using Synthetic Mesh

Introduction: The products that have been developed to enhance implant based breast reconstruction are either acellular dermal matrix (ADM) or synthetic mesh. Although versatile, ADM is considerably expensive. The titanium-coated polypropylene mesh (TiLoop® Bra) is an alternative with good biocompatibility and is less costly than acellular dermal matrix. The purpose of this study is to evaluate the clinical results observed in patients who underwent direct to implant breast surgery with the additional use of titanium - coated polypropylene mesh. Materials and Methods: We present a retrospective review of 20 patients who underwent single-stage implant breast reconstruction (26 breasts) with the use of TiLoop® Bra after oncologic (n=18) or prophylactic mastectomy (n=8). The surgery included: inferolateral incision, skin sparing mastectomy, applying the titanium mesh along the inframammary fold to fix the position of the inferior pectoral edge, and along the lateral border to fix the implant position and prevent lateral migration. Results: The mean follow-up at the time of review was 24 months. The reported complications included: two seromas; one wound dehiscence; revision surgery with explantation of the implant due to necrosis of the nipple-areola complex in one case. Malposition of the implants was not observed. Conclusion: The titanium-coated polypropylene mesh is an effective alternative to acellular dermal matrix in breast reconstruction and seems to be a helpful tool for implant stabilization. In comparison to ADM, TiLoop® Bra is cheaper and the results are promising.