Surgical Studies of Reconstructive Breast Surgery – An Overview of the Topics at the 2019 Annual Meeting of the Working Group for Reconstructive Surgery in Oncology-Gynecology

Abstract

This yearʼs annual AWOgyn meeting focused on studies of reconstructive breast surgery. As the majority of breast reconstructions are implant-based, most studies also focused on implant-based reconstruction. Since 2011, the guidelines have recommended using interposed mesh materials as support. The basic idea behind every type of material is to provide coverage and stabilization for the implant by constructing an “internal bra” which will create the appropriate implant shape and maintain the position, stability and flexibility of the implant. The Working Group for Reconstructive Surgery in Oncology-Gynecology (AWOgyn) has undertaken to analyze different materials with regard to indications, success rates and side effects as documented in registers, clinical assessments and study protocols. This has increased application safety and is expected to improve it even further in future. Prospective studies are being carried out to investigate issues such as the optimal material, optimal implant site and best cosmetic results. The first results for porcine and human acellular matrices and for partially resorbable titanium-coated synthetic polypropylene meshes are now available. In 2019, the AWOgyn working group will be launching further studies to evaluate a perforated acellular dermal matrix (Fortiva®), a titanium-coated implant pocket (TiLOOP® Bra Pocket) and a fully resorbable synthetic mesh (TIGR®mesh).

Clinical practice guidelines for post-mastectomy breast reconstruction: Chinese Society of Breast Surgery (CSBrS) practice guidelines 2021

“…The strength and thickness of prosthesis coverage during prosthetic breast reconstruction are key factors that determine the appearance of the breast after reconstruction. Patches used for breast reconstruction can be divided into two categories: patches made of bioderived materials, such as acellular dermal matrix, [ 17 – 19 ] and patches made of synthetic materials, such as titanium-coated polypropylene mesh. [ 18 , 19 ]…”

“…Patches used for breast reconstruction can be divided into two categories: patches made of bioderived materials, such as acellular dermal matrix, [ 17 – 19 ] and patches made of synthetic materials, such as titanium-coated polypropylene mesh. [ 18 , 19 ]…”

“…The strength and thickness of prosthesis coverage during prosthetic breast reconstruction are key factors that determine the appearance of the breast after reconstruction. Patches used for breast reconstruction can be divided into two categories: patches made of bioderived materials, such as acellular dermal matrix, [17][18][19] and patches made of synthetic materials, such as titanium-coated polypropylene mesh. [18,19] With advances in breast cancer diagnosis and treatment concepts as well as socioeconomic and cultural development in China, the aesthetic requirements of breast cancer patients are gradually increasing, as is the percentage of patients undergoing breast reconstruction.…”

Synthetic Mesh in Immediate Breast Reconstruction

“…A summary of all these data is shown in Table 1. A number of studies are currently underway in Europe [64]. It is well known that radiotherapy has a significantly detrimental effect on most breast reconstruction outcomes, whether given pre-or postoperatively (but without differences in complication rates between both) [65], since it impedes neovascularisation and mesh incorporation into the host [1].…”

Prepectoral implant-based breast reconstruction with TiLOOP® Bra Pocket – a single-centre retrospective study

“…TiLOOP ® Bra Pocket (pfm medical, Cologne, Germany) is made of nonresorbable, titanized, lightweight polypropylene. The Bra Pocket is a novel, ready-to-use mesh pocket designed to ensure optimal fixation of the breast implant 23 . Serving as an ´internal bra´ the mesh pocket provides coverage and stabilization for the implant by creating an inferior and lateral sling.…”