Can titanium mesh influence local recurrence management after implant-based breast reconstruction?

Area of Science:

• Plastic Surgery
• Oncology
• Biomaterials Science

Background:

• TiLOOP® Bra, a permanent titanium-coated polypropylene mesh, is used for post-mastectomy breast reconstruction.
• While generally considered to cause low-grade inflammation, its side effects are not widely reported.
• This case highlights potential complications in immediate implant-based reconstruction.

Purpose of the Study:

• To describe a case of granuloma formation associated with TiLOOP® Bra mesh in breast reconstruction.
• To discuss the differential diagnosis between granulomas and local recurrence.
• To propose strategies for prevention and management of mesh-related complications.

Main Methods:

• A patient with ductal carcinoma in situ underwent mastectomy and immediate reconstruction with TiLOOP® Bra mesh.
• Follow-up revealed nodules, complicated by granulomatous reaction near mesh fixation sites.
• Histopathological examination was necessary for definitive diagnosis.

Main Results:

• The case demonstrated granuloma formation in the inframammary fold, likely at mesh folding or fixation points.
• This reaction complicated the diagnosis of a potential local tumor recurrence.
• The findings underscore a potential side effect of titanium-coated permanent mesh.

Conclusions:

• A modified surgical technique is proposed to minimize granuloma formation during mesh placement.
• Subcutaneous nodules post-reconstruction require thorough investigation to rule out local recurrence.
• Prompt evaluation and potential excision of nodules are recommended for high-risk patients.