Meshes in Implant-Based Breast Reconstruction: The Science and Technology

Abstract

Breast reconstruction is a common choice post mastectomy or breast-conserving surgery for breast cancer. Reconstructive options currently include implant-based and autologous reconstruction, with adjunctive use of surgical meshes. Acellular dermal matrices (ADMs) of both human and animal origin, and synthetic meshes are well-established for use in implant reconstruction. With ADMs, there is reduced risk of capsular contracture, providing a strong scaffold for prosthetic-based immediate reconstruction. Reduced seroma formation and infection has been demonstrated with synthetic mesh, thus both techniques proving advantageous. Use of mesh in implant-based reconstruction is a quickly evolving field, with hybrid meshes, 3D printed meshes and antibiotic-loaded meshes being investigated within the current literature. Whilst these surgical techniques are relatively new, they provide a new approach to many of the ethical issues currently surrounding use of surgical mesh.