Additional tissue support in breast surgery first became more common when acellular dermis ( cadaver dermis washed of all offending agents ) was introduced for breast cancer reconstruction. Placing a sheet of tissue in the lower part of the breast post mastectomy allowed more effective immediate breast reconstruction and revolutionized the field. These sheets, however, also had problems. A drain was necessary, they did not always incorporate into the native tissue well, and they were very expensive. Accordingly, use has been limited in aesthetic breast surgery.
Absorbable mesh has now improved to the point that it is a good option for aesthetic breast surgery. These meshes do not require a drain in some setting, incorporated into the surrounding breast and are replaced by stronger scar tissue in 1-2 years, and are more reasonably priced. As with any new product and aesthetic surgery, we do not have large studies confirming outcomes and surgeons must depend upon their own experience.
Thus far I have found meshes useful to limit descent of lifted or augmented breasts. There are also some studies to support using mesh to minimize recurrent capsular contractures, so I have applied mesh here as well with some good results. Galatea was the first mesh common in the market and is useful in some applications. More recently, I have used DuraSorb because it is less expensive, molds easier, and is replaced by scar in one year as opposed to two. I plan to use both products as indicated.
Visit my Mesh Gallery page for a few case examples.
