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Updated: Jun 6, 2026
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Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction
Published on: May 17, 2024
Mesh-free prepectoral breast reconstruction: a safe and effective alternative
Jun Zhang1, Hai-Kuo Yu1, Zi-Fan Liu2
1Thyroid and Breast Medical Center, Weifang People's Hospital, Shandong Second Medical University, Weifang, Shandong, China.
Frontiers in Oncology
|June 5, 2026
Summary
Mesh-free prepectoral breast reconstruction (PBR) is a safe and cost-effective alternative to mesh PBR, offering reduced operative time and lower hospitalization costs without compromising major complication rates or patient satisfaction.
Area of Science:
- Plastic Surgery
- Oncology
- Reconstructive Surgery
Background:
- Prepectoral breast reconstruction (PBR) is an increasingly popular option for post-mastectomy reconstruction due to its benefits.
- Current PBR often utilizes mesh (e.g., acellular dermal matrix or synthetic) for soft tissue coverage and complication reduction.
- Mesh use in PBR introduces concerns regarding cost, infection, and foreign body reactions.
Purpose of the Study:
- To compare clinical and aesthetic outcomes of prepectoral breast reconstruction with mesh versus without mesh in breast cancer patients.
- To evaluate the safety, efficacy, and cost-effectiveness of mesh-free PBR.
- To identify advantages of mesh-free PBR, particularly in patients undergoing radiotherapy.
Main Methods:
- Retrospective analysis of 246 breast cancer patients undergoing PBR.
- Patients divided into mesh-free (128) and mesh (118) groups.
- Comparison of perioperative indicators, postoperative complications, cost analysis, and BREAST-Q quality of life scores; subgroup analysis for radiotherapy patients.
Main Results:
- No significant differences in major complication rates (infection, capsular contracture, implant loss) between mesh-free and mesh groups.
- Mesh-free PBR demonstrated significantly shorter operative times (p<0.001) and lower hospitalization costs (p<0.001).
- Mesh-free group reported higher physical well-being scores (p=0.005), with no significant differences in overall satisfaction or other quality-of-life domains.
Conclusions:
- Mesh-free prepectoral breast reconstruction is a safe and cost-effective approach for selected breast cancer patients.
- This technique offers advantages in operative time and cost without compromising safety or aesthetic outcomes.
- Mesh-free PBR may be particularly beneficial for patients requiring postoperative radiotherapy.