| Abstract [eng] |
Background: Breast cancer is the most common cancer among women. Implant-based breast reconstruction plays an important role after mastectomy due to breast cancer or genetic predisposition and helps to restore feminine body contours. Biological (acellular dermal matrix) and synthetic meshes are commonly used to support the implant or expander. Although outcomes with meshes are promising, studies have reported contradictory findings. The aim of this study is to provide an overview of some of the literature on mesh-assisted implant-based breast reconstruction and to analyze the clinical benefits, complication rates, and differences between biological and synthetic meshes in implant-based breast reconstruction. Method: A literature review was conducted using electronic databases, such as PubMed and Google Scholar. A total of 80 articles were included for analysis. Results: Biological and synthetic meshes are used globally in subpectoral and prepectoral breast reconstruction. They are applied in both one-stage and two-stage breast procedures involving a tissue expander. Commonly investigated biological meshes include AlloDerm, Braxon, and Strattice; synthetic mesh examples are Vicryl Mesh and TIGR Matrix. Reported complication rates varied depending on the mesh type and study design. Common complications included seroma, infections, necrosis, and implant loss or the need for reoperation. Several studies found no statistically significant differences between biological and synthetic meshes regarding overall complication rates. However, synthetic meshes were often associated with lower infection and seroma rates, and they offer significant cost advantages. Patient-reported outcome measures showed similarly favorable results across mesh types. Conclusions: Both biological and synthetic meshes provide valuable support in implant-based breast reconstruction and lead to overall satisfactory aesthetic and functional outcomes. No single mesh type appears superior in all aspects. Meshes should not be applied on a routine basis. Instead, mesh selection should be individualized based on patient-related factors, anatomic conditions, implant size, costs, patient preference, and the surgeon’s experience. While synthetic meshes offer notable cost benefits and comparable safety, further research with standardized outcome reporting and extended follow-up periods is needed to optimize clinical decision-making and mesh selection. |
