Serasynth Mesh BR Pocket in Prepectoral Direct-to-implant and Tissue-expander Breast Reconstruction: A Retrospective Single-center Analysis

Background: Prepectoral implant-based breast reconstruction after nipple-sparing mastectomy or skin-sparing mastectomy has already shown several advantages. Synthetic meshes are often used as a supportive layer to achieve satisfying and stable results. We present our data using Serasynth Mesh BR Pocket, a fully dissolvable, ready-to-use mesh pocket. Methods: Between December 2021 and August 2023, a single-center retrospective study evaluated 53 breast reconstructions (43 patients) for short-term complications. Complications were classified as major (requiring revision surgery) or minor (managed conservatively). All patients underwent nipple-sparing mastectomy or skin-sparing mastectomy followed by direct-to-implant or direct-to-expander reconstruction using Serasynth Mesh BR Pocket. The minimum follow-up was 4 weeks. Results: Of 53 breasts, 44 (83%) required no further surgical intervention, with a mean follow-up of 10 months (range 1–20, mo). Major complications occurred in 9 breasts (17%), and minor complications occurred in 13 (24.5%). Implant loss (13.2%) was primarily due to necrosis (7.5%). A higher body mass index (≥27 kg/m 2 ) and axillary lymph node excision were associated with an increased risk of complications. Notably, 41.9% of patients received adjuvant radiotherapy. Conclusions: Serasynth Mesh BR Pocket demonstrates a favorable safety profile in prepectoral breast reconstruction, even in a high-risk cohort with substantial radiotherapy exposure. Outcomes are comparable to those of other synthetic meshes, with the added benefit of full resorbability. Careful patient selection, considering body mass index, soft-tissue quality, and lymph node dissection, is essential to optimize results.