Clinical Outcomes of Ovine-Reinforced Hybrid Mesh (OviTex) in Alloplastic Breast Reconstruction

This study examines clinical outcomes of Ovine-Reinforced Hybrid Mesh (OviTex) in alloplastic breast reconstruction by a single surgeon.

A retrospective chart review was conducted on patients who underwent immediate or delayed breast reconstruction with OviTex between 2019 and 2023 without indocyanine green angiography. Outcomes analyzed included reoperation rates, implant exposure, infection, seroma, and hematoma. Even in patients with thin mastectomy skin flaps, immediate reconstruction was essentially performed whenever planned.

Seventy-nine patients (134 breasts) were included. The majority of reconstructions involved direct-to-implant procedures (65% vs 35% tissue expander), with a predominance of immediate reconstructions (97% vs 3% delayed) and prepectoral placement (72% vs 28% dual-plane). Reoperation occurred in 29 breasts (22%), all in immediate reconstructions, primarily due to exposure (20%), infection (10%), or a combination of both (8%). Four breasts (3%) developed a seroma, two of which also required surgical intervention for exposure. No hematomas were observed. Reoperation was significantly more likely on breasts treated direct-to-implant compared to those with tissue expanders ( P  < 0.001) and on the cancer side compared to prophylactic reconstructions ( P  < 0.001). No significant differences in reoperation were noted regarding placement location (prepectoral vs dual-plane) or radiation treatment.

This study provides clinical outcomes on OviTex use in alloplastic breast reconstruction. Reoperation was significantly more likely in direct-to-implant reconstruction and on the side with cancer, likely due to skin flap perfusion rather than intrinsic mesh properties. The lack of access to indocyanine green angiography, as others have reported, in all likelihood contributed to the higher-than-expected rate of reoperation. In addition, significantly smaller implants might have led to a higher rate of reconstructive success.