Women equally satisfied with biologic, synthetic meshes after breast reconstruction

Biologic and synthetic meshes for implant-based immediate breast reconstruction elicit comparable levels of patient satisfaction, reports a new study.

The study included 21 patients, all of whom received prophylactic bilateral mastectomy and subsequent dual-plane reconstruction. Patients’ breasts were randomized preoperatively to receive either a biological or synthetic mesh. The study endpoint was patient-reported outcomes (PROMs), as measured by the BREAST-Q.

Satisfaction analyses showed no mesh type was clearly superior to the other. Most participants were equally satisfied or dissatisfied with both synthetic and biologic meshes in terms of bra size, softness, natural feel, appearance compared to before surgery, and wrinkles.

Of the PROM domains assessed, participants most notably felt the difference between the two mesh types as regards natural appearance, visible wrinkles, and feel to touch.

Among women who had felt differences between the two mesh types, more thought that biological meshes were better in terms of natural appearance and overall appearance relative to the preoperative state, while synthetic meshes were superior in terms of bra size.

Of note, some biological meshes bottomed out.

“Biological and synthetic meshes seem to give rise to different types of reconstructed breasts, and more studies are needed regarding whether knowledge about the effects of different meshes can be used to tailor breast reconstructions to individual patients wishes,” the researchers said.

“The rate of complications and corrections in the biological mesh breasts is higher, which must be considered when type of mesh is chosen,” they added.