A Comparative Analysis of Complications and Patient-Reported Outcomes in Implant-Based Breast Reconstruction with Polytetrafluoroethylene (PTFE) versus Allogeneic Dura Mater (DM).

Objective: Mastectomy with immediate reconstruction is a primary surgical treatment for breast cancer. While both synthetic meshes and biological grafts are used in these procedures, their comparative effectiveness requires further investigation. This study evaluates the use of polytetrafluoroethylene (PTFE) mesh versus allogeneic dura mater (DM) in direct-to-implant breast reconstruction for reinforcing the inframammary fold (IMF) and stabilizing the implant. Materials and Methods: A prospective, randomized, open-label trial enrolled 116 patients (192 breasts) who underwent subcutaneous or skin-sparing mastectomies or subtotal radical resections, all followed by immediate subpectoral implant-based reconstruction. Participants were randomized to receive either a PTFE mesh (60 patients; 96 breasts) or a DM graft (56 patients; 96 breasts) for implant support. Outcomes were assessed through radiological imaging for complications, anthropometric measurements for IMF and implant stability, and the breast evaluation questionnaire version 2.0 Results: The PTFE group demonstrated a lower rate of major complications (3 vs. 7, respectively), while minor complications were comparable (23 vs. 28, respectively). Anthropometric analysis demonstrated that PTFE mesh provided superior stabilization of the IMF and the implant position postoperatively. Quality of life scores were comparable between the two groups. Conclusion: The use of PTFE mesh in immediate subpectoral breast reconstruction provides reliable anti-gravitational stabilization of the IMF and implant, and is associated with a favorable complication profile and high patient-reported quality of life.