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Polydioxanone Monofilament Mesh: A Safety Net for Complex Breast Implant Revision Surgery

BACKGROUND: Breast revision surgeries are complex cases requiring greater pocket control than primary surgeries. Intraoperative techniques to maximize pocket integrity are crucial to achieving an aesthetic result in revisions with implants. OBJECTIVES: Uniform utilization of a polydioxanone (PDO) in...

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Autores principales: Chiemi, Julia A, Kelishadi, S Sean
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9942435/
https://www.ncbi.nlm.nih.gov/pubmed/36318791
http://dx.doi.org/10.1093/asj/sjac278
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author Chiemi, Julia A
Kelishadi, S Sean
author_facet Chiemi, Julia A
Kelishadi, S Sean
author_sort Chiemi, Julia A
collection PubMed
description BACKGROUND: Breast revision surgeries are complex cases requiring greater pocket control than primary surgeries. Intraoperative techniques to maximize pocket integrity are crucial to achieving an aesthetic result in revisions with implants. OBJECTIVES: Uniform utilization of a polydioxanone (PDO) internal support matrix in a high volume of revision-augmentation cases has, to our knowledge, never before been described. METHODS: A high-volume (n = 104) single-surgeon experience followed patient outcomes in consecutive cases from September 2020 to March 2022. Included in this cohort were patients undergoing revision-augmentations with vertical or wise-pattern mastopexies (n = 74), revision-augmentation without mastopexies (n = 25), and revision without implant exchange (n = 5). Each case employed at least 1 sheet of PDO mesh, with a small set (n = 4) receiving 2 sheets. Patients were followed up (range, 3-19 months), with 3 months minimum follow-up to assess outcomes. RESULTS: The average length of follow-up was 8.8 months. Patients in this cohort had undergone an average of 1.6 prior breast surgeries (range, 1-7). A total 89.4% of patients received an increase in implant volume (average change, +165.2 Cc); 87.5% of patients had favourable aesthetic outcomes, and 12.5% of patients were reoperated on (including reoperations for complications and/or aesthetic reasons). There were 13 complications in the cohort, and no mesh-related complications. CONCLUSIONS: PDO mesh is a safe and effective method of increasing pocket control in breast revision. Supplemental soft-tissue support allowed greater implant volumes to be employed, yielding high rates of patient satisfaction with breast shape, scarring, and long-term aesthetics. LEVEL OF EVIDENCE: 4: [Image: see text]
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spelling pubmed-99424352023-02-22 Polydioxanone Monofilament Mesh: A Safety Net for Complex Breast Implant Revision Surgery Chiemi, Julia A Kelishadi, S Sean Aesthet Surg J Original Article BACKGROUND: Breast revision surgeries are complex cases requiring greater pocket control than primary surgeries. Intraoperative techniques to maximize pocket integrity are crucial to achieving an aesthetic result in revisions with implants. OBJECTIVES: Uniform utilization of a polydioxanone (PDO) internal support matrix in a high volume of revision-augmentation cases has, to our knowledge, never before been described. METHODS: A high-volume (n = 104) single-surgeon experience followed patient outcomes in consecutive cases from September 2020 to March 2022. Included in this cohort were patients undergoing revision-augmentations with vertical or wise-pattern mastopexies (n = 74), revision-augmentation without mastopexies (n = 25), and revision without implant exchange (n = 5). Each case employed at least 1 sheet of PDO mesh, with a small set (n = 4) receiving 2 sheets. Patients were followed up (range, 3-19 months), with 3 months minimum follow-up to assess outcomes. RESULTS: The average length of follow-up was 8.8 months. Patients in this cohort had undergone an average of 1.6 prior breast surgeries (range, 1-7). A total 89.4% of patients received an increase in implant volume (average change, +165.2 Cc); 87.5% of patients had favourable aesthetic outcomes, and 12.5% of patients were reoperated on (including reoperations for complications and/or aesthetic reasons). There were 13 complications in the cohort, and no mesh-related complications. CONCLUSIONS: PDO mesh is a safe and effective method of increasing pocket control in breast revision. Supplemental soft-tissue support allowed greater implant volumes to be employed, yielding high rates of patient satisfaction with breast shape, scarring, and long-term aesthetics. LEVEL OF EVIDENCE: 4: [Image: see text] Oxford University Press 2022-11-02 /pmc/articles/PMC9942435/ /pubmed/36318791 http://dx.doi.org/10.1093/asj/sjac278 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of The Aesthetic Society. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Original Article
Chiemi, Julia A
Kelishadi, S Sean
Polydioxanone Monofilament Mesh: A Safety Net for Complex Breast Implant Revision Surgery
title Polydioxanone Monofilament Mesh: A Safety Net for Complex Breast Implant Revision Surgery
title_full Polydioxanone Monofilament Mesh: A Safety Net for Complex Breast Implant Revision Surgery
title_fullStr Polydioxanone Monofilament Mesh: A Safety Net for Complex Breast Implant Revision Surgery
title_full_unstemmed Polydioxanone Monofilament Mesh: A Safety Net for Complex Breast Implant Revision Surgery
title_short Polydioxanone Monofilament Mesh: A Safety Net for Complex Breast Implant Revision Surgery
title_sort polydioxanone monofilament mesh: a safety net for complex breast implant revision surgery
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9942435/
https://www.ncbi.nlm.nih.gov/pubmed/36318791
http://dx.doi.org/10.1093/asj/sjac278
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