A Novel Application of the Hemostatic Net in Aesthetic Breast Surgery: A Preliminary Report

Abstract

Background Obtaining optimum breast aesthetics can be challenging in secondary aesthetic breast surgery, particularly with poor quality skin, when downsizing implants and in cases where patients will not accept additional mastopexy scars. Most techniques described in these cases rely on internal suturing and capsulorrhaphy, which can lack precision in tailoring the skin over the internal pocket. Objectives The authors present their experience using the haemostatic net to help address a range of challenging breast cases in their practices. Methods A multi-centre retrospective analysis of patients undergoing aesthetic and reconstructive breast surgery between 2019 and 2021 was conducted. A database was established to record patient demographics, indications for surgery, surgical technique and complications. Following capsulorrhaphy, the haemostatic net was applied in as many rows as required with monofilament sutures and removed 3-7 days post-operatively. Results Twenty-four women (23-67 years) underwent aesthetic or reconstructive breast surgery using the haemostatic net. This approach optimised the stabilisation of the infra-mammary crease and re-draping of lax skin or irregularities in the skin envelope. At follow up review, only one instance of the net failing to successfully redrape the skin was seen. Conclusions The application of the haemostatic net is an option in patients who might otherwise require mastopexy but refuse to accept the scars. The technique has now been extended to primary cases where implant malposition or skin tailoring issues are anticipated, thus securing its place as a part of the surgical armamentarium

Evolution of the Surgical Net

“…It has also found use in managing dead space after large lipoma resection. 23 Additional utilization spans lateral breast liposuction, abdominoplasty, and one such publication on supratip finetuning in rhinoplasties. 24,25 It has been leveraged to avoid hematoma after gynecomastia surgery and continues to find use in skin grafts, flaps, latissimus donor sites, and other breast surgeries, as well as the continued treatment of axillary hyperhidrosis.…”