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Larger implants, better implant position possible with use of Vicryl mesh extension

Using Vicryl mesh extension in one-stage immediate breast reconstructions, researchers found larger implants were possible, with the potential for better implant positioning and no increase in complications.

The researchers reviewed 161 immediate breast reconstruction cases in 139 patients at Geneva University Hospitals between 2002 and 2010. Forty-six breasts had a complete submuscular pocket, whereas submuscular pockets were completed in 115 breasts using a Vicryl mesh.

Patients in the two groups did not vary statistically in terms of oncologic characteristics, according to the researchers.

During a mean follow-up of 45.8 months for the mesh group and 62.8 months for the non-mesh group, the researchers assessed rates of early and late complications, surgical revisions, size of implants, and instances of contralateral breast procedures and compared findings between the two groups.

Early complications, or those that occurred within 90 days postoperative, included hematoma, periprosthetic infection, skin necrosis and wound dehiscence. Late surgical revisions were those that occurred after 90 days postoperatively and included implant malposition/ inframammary fold asymmetry, volume asymmetry and capsular contracture.

Although the rates of early and late revisions were similar between the two groups, the researchers found fewer revisions due to malpositioned implants in the mesh group. Additionally, patients with mesh were able to receive significantly larger implants; mean implant volume in the mesh group was 329 g vs. 284 g in the non-mesh group.

According to the researchers, patients in the mesh group had fewer contralateral mastopexies, and the Vicryl mesh extension found to be a low-cost alternative compared with biological matrices or tissue expanders. - by Abigail Sutton

Disclosure: The researchers report no relevant financial disclosures.