The Role of Synthetic Meshes in Revision Surgery After Breast Augmentation: A Personal Experience.

Background/Objectives: The breast implant exchange/explantation rate has been increasing in recent years due to various types of long-term complications or adverse effects, such as implant migration, rippling, or capsular contracture. To reduce complications such as migration and/or implant-pocket mismatch, surgical meshes may provide implant support. Here, we present a case series about the use of a non-absorbable synthetic bra-shaped mesh in revision surgery of the breast, using implants that do not adhere to the surrounding tissues. Methods: In this retrospective case series, eight patients underwent breast revision surgery between 2021 and 2024 due to implant-related long-term complications following aesthetic surgery. Surgical revision included implant exchange, total or partial capsulectomy, creation of a pre-pectoral implant pocket for the new implant, and positioning of the non-absorbable synthetic mesh, acting as an internal support for the implants. BREAST-Qs were collected from all patients. Results: Of the eight patients included, the following symptoms were observed: symptomatic capsular contracture (n = 3), implant migration (n = 4), and breast animation deformity (n = 2). After revision surgery, during the follow-up period of 6-42 months, neither infection nor seroma occurred. No implant-related complications were registered. The BREAST-Q analysis revealed the highest patient satisfaction in the domain "satisfaction with the implants" (median score 87.5%). Conclusions: In revision surgery after breast augmentation, the synthetic, non-absorbable and titanized pocket-like mesh may provide implant support and avoid recurrence of complications related to implant position. However, due to the small and heterogeneous patient group, larger studies are needed to validate these preliminary findings.