Polydioxanone Monofilament Mesh: A Safety Net for Complex Breast Implant Revision Surgery.

Area of Science:

• Plastic Surgery
• Reconstructive Surgery
• Aesthetic Surgery

Background:

• Breast revision surgeries present unique challenges requiring superior pocket control compared to primary procedures.
• Achieving optimal aesthetic results in revision breast augmentation with implants necessitates robust intraoperative techniques for pocket integrity.

Purpose of the Study:

• To describe the uniform utilization of a polydioxanone (PDO) internal support matrix in a high-volume cohort of breast revision-augmentation cases.
• To evaluate patient outcomes and safety associated with using PDO mesh in revision breast surgery.

Main Methods:

• A high-volume, single-surgeon study included 104 consecutive revision breast surgery cases between September 2020 and March 2022.
• The cohort comprised revision-augmentations with mastopexies, revision-augmentations without mastopexies, and revisions without implant exchange.
• Each patient received at least one sheet of PDO mesh, with follow-up ranging from 3 to 19 months.

Main Results:

• The average follow-up was 8.8 months, with patients having undergone an average of 1.6 prior breast surgeries.
• 89.4% of patients received increased implant volume, and 87.5% reported favorable aesthetic outcomes.
• Reoperation was required in 12.5% of cases; 13 complications occurred in total, with no mesh-related issues.

Conclusions:

• Polydioxanone (PDO) mesh is a safe and effective adjunct for enhancing pocket control in breast revision surgeries.
• The supplemental soft-tissue support facilitated the use of larger implant volumes, contributing to high patient satisfaction with breast shape, scarring, and overall aesthetics.