Assisted Breast Reconstruction With Biosynthetic Mesh and Implants: A Pilot Study

Summary: The use of acellular dermal matrix in implant-based breast reconstruction has been associated with high complication rates. A biosynthetic mesh (GORE BIO-A) may reduce the incidence of complications while maintaining similar functional characteristics. No study has evaluated this material exclusively. This article sought to fill this gap by presenting a retrospective analysis of patients at high risk for complications (13 patients; 23 breasts), who underwent immediate implant-based breast reconstruction with GORE BIO-A. The mean age of this cohort was 41.8 years (range: 31–56 y). The mean follow-up period was 15.6 months (3–44 mo), and the mean implant volume was 383 mL (330–490 mL). Early complications occurred in 6 breasts, all managed conservatively. The Baker classification for capsular contracture showed grade I in 18 breasts. Radiotherapy affected capsular contracture ( P = 0.03). Of the 10 breasts that underwent radiotherapy, 4 had grade III contracture. Based on the Harvard scale and BCCT.core evaluations, the aesthetic outcome was rated as good or excellent in 11 of 13 and in 12 of 13 cases, respectively. The EORTC QLQ-BREC23 questionnaire used to assess quality of life showed high levels of satisfaction with the surgery (100.0%), the breast (77.8%), and nipple preservation (100.0%). Few side effects were recorded. Although further studies are required, these outcomes indicate that, in high-risk groups, breast reconstruction using the GORE BIO-A biosynthetic matrix may be feasible, with acceptable complication rates and good quality-of-life outcomes.