Revision Breast Reconstruction With Biologic or Synthetic Mesh: An Analysis of Post-Operative Capsular Contracture Rates

Abstract

Abstract Background Both biologic and synthetic mesh have been found to reduce the risk for capsular contracture, yet there is limited data assessing the use of these scaffold materials in revision breast reconstruction surgery. Objectives This investigation sought to assess the ability of either biologic or synthetic mesh to prevent capsular contracture in the revision breast reconstruction population. Methods A retrospective chart review was conducted of implant-based revision reconstructions performed by the senior author between 2008 and 2023. Patient demographics and outcomes were assessed, including the incidence of Baker grade III or IV capsular contractures. Results were compared between biologic and synthetic mesh groups using univariate and multivariate analysis. Results Ninety-five breasts underwent revision reconstruction with 90 (94.7%) for correction of malposition, four (4.2%) for size change, and one (1.1%) for revision after additional oncologic breast surgery. Of these breasts, 26 (27.4%) used biologic mesh and 69 (72.6%) used synthetic mesh. Capsular contracture occurred in one (3.8%) biologic mesh breast and four (5.8%) synthetic mesh breasts. There was no significant difference in the incidence of capsular contracture between the two groups (p=1.000). None of the recorded demographics were risk factors for capsular contracture, including the use of biologic or synthetic mesh (p=0.801). Conclusions Both biologic and synthetic mesh are successful at preventing capsular contracture in patients undergoing implant-based revision reconstruction. This adds to the growing evidence that both scaffold materials can be used in complex revision breast reconstruction to aid in preventing capsular contracture.