Early experience with implant based breast reconstruction for early breast cancer in ptotic breasts with non biological mesh and lower pole dermal sling

Abstract

Aim: Evaluation of early experience with implant based breast reconstruction for early breast cancer in ptotic breasts with titanium coated polypropylene mesh and lower pole dermal sling. Methods: A pilot prospective ongoing study where patients having immediate implant based reconstruction with non biological mesh and lower pole dermal sling are evaluated simultaneously. Patient, surgical, and tumour related factors are presented as well as the cosmetic outcome in five patients, two of whom underwent bilateral procedure for bilateral breast cancer and one who underwent simultaneous symmetrisation with reduction mammoplasty on the contralateral side. Results: All five patients had good cosmetic outcome with minor complications. There was no delay in adjuvant treatment due to complications. All were satisfied with their results and would recommend this treatment to others. Conclusion: Using a non biological mesh as well as a lower pole dermal sling, which covers the suture line and offers an extra layer of protection to the mesh, reduces the complication rate especially in patients who may be at higher risk of wound related problems such as those with increased body mass index. This procedure is also cost effective (non biological meshes are only 1/5th of the cost compared to biological meshes) and provides equivalent cosmetic outcomes in a select group of patients.

Autologous coverage for direct-to-implant pre-pectoral reconstruction in large and ptotic breasts: a new technique

“…Large and ptotic breasts have usually a wide base and, consequently, implants are keener to lateral and superior movements. In subpectoral reconstruction the muscle itself prevents the implant to move in a superior direction, while the use of a serratus fascia flap [ 26 ], meshes [ 27 , 28 ] or the ‘dermal cage’ technique [ 29 ] have been described to avoid later displacement. In pre-pectoral reconstruction, instead, ADMs or non-biological mesh are needed to fix the implant to the chest wall in a proper position [ 14 , 15 ]; nevertheless, these products do not come without complication and adjunctive cost to the procedure [ 17–20 ].…”

One-Stage Immediate Alloplastic Breast Reconstruction in Large and Ptotic Breasts: An Institutional Algorithm

“…The combination of matrices with the inferior dermal flap has been reported in the literature. Some authors [23,24] have described the use of matrices to cover the inferolateral aspect of the implant in a submuscular reconstruction; this provides a two-layer coverage of the inferior pole of the implant as the dermal flap is draped over the matrix. Others [25,26], instead, described their use in pre-pectoral reconstruction; matrices can be sutured to the superior border of the dermal flap and placed to cover the superior pole of the implant, or they can be used as a means for total implant coverage under the dermal flap.…”