Usefulness of meshed SurgiMend in direct-to-implant breast reconstruction

Implant-based breast reconstruction after mastectomy is becoming more common because it has several advantages. It is a simpler surgical procedure than other methods, such as breast reconstruction using flaps, and it allows faster patient recovery with no additional scars [1]. However, implants are placed below the pectoralis major muscle because complications such as infection, capsular contracture, and explantation are likely to occur when implants are directly exposed [2-5]. After acellular dermal matrix (ADM) was developed in 2005, surgery with inferolateral tissue support has been performed to compensate for the disadvantages of total muscle coverage [6-8]. Despite the advantages of ADM such as good cosmetic outcomes, additional reinforcement, improved implant positioning, and a reduced risk of capsular contracture [9], seroma, infection, and inflammation are possible when ADM is used, and ADM also has the disadvantage of a high cost [10]. Surgery using ADM fenestration is widely performed because previous studies have reported that this technique leads to better cosmetic outcomes, results in fewer complications such as seroma, and stimulates biointegration [11-15]. However, fenestrating ADM during surgery can be cumbersome because the surgeon has to make pores one by Pil Seon Eo, Joon Seok Lee, Jeong Woo Lee, Kang Young Choi, Ho Yun Chung, Byung Chae Cho, Jeeyeon Lee, Ho Yong Park, Jung Dug Yang