Bioabsorbable Polydioxanone Mesh for Soft Tissue Reinforcement in Revisional Breast Surgery.

Background: The need for revision procedures after breast implant surgery often arises from the failure of soft tissues to provide a stable implant pocket. Meshes or dermal matrices have been used to reinforce the implant's soft tissue support. Durasorb (Surgical Innovation Associates, Chicago, IL) is a resorbable polydioxanone (PDO) mesh indicated for soft tissue reinforcement. Its monofilament, macroporous design allows for ease of handling and rapid tissue incorporation. The extended timeline of PDO bioabsorption provides support during the critical portions of soft tissue healing while avoiding long-term complications of permanent products. Objectives: Evaluate the efficacy of Durasorb PDO mesh for soft tissue reinforcement in revision breast surgery. Methods: This is a prospective case series of 17 patients (27 breasts) undergoing revision breast implant surgery with Durasorb PDO mesh. Results: Five patients (5 breasts) presented for revision after implant placement for breast reconstruction, with the remaining 22 presenting for revision after implant placement for cosmetic indications. Average patient age was 47.9 years, and average BMI 24.3. Indications for surgery were implant malposition (37%), capsular contracture (30%), poor cosmesis/asymmetry (26%), and recurrent soft tissue ptosis (7%). Follow up averaged 355 days (range 174 to 799 days, SD=155). One patient experienced a seroma 2 weeks post-operatively, which resolved after a single aspiration. No infections, wound healing problems, or recurrences of implant malposition/capsular contracture were encountered. Conclusions: Durasorb PDO mesh appears to be efficacious as a breast implant pocket reinforcement in the reoperative setting with a low complication rate and durable results. Level of Evidence 4: