The use of acellular dermal allograft or xenograft has gained acceptance in breast reconstruction as an adjunct to maintain expander position and assist in reconstruction of the inframammary fold. We report the use of Vicryl® (polyglactin) mesh for similar purposes in 24 breast reconstructions (20 patients, 17 immediate, 3 delayed). Mean follow up at time of submission was 7.3 months. The mesh was used along the inframammary fold to maintain position of the inferior pectoral edge, and /or along the lateral border to maintain expander position and prevent lateral migration.
Results: Two seromas occurred (8.3%), one of which became infected (4.2%) requiring expander removal. In eight breasts the expander has been replaced with an implant. The capsule was normal in appearance, and as expected, no visible mesh remained. Expander malposition did not occur in any breast where mesh was utilized. In six patients, mesh was used on only one side of a bilateral reconstruction – in one of these six (17%), malposition occurred on the side where mesh was not utilized.
Conclusion: Vicryl® mesh is an effective alternative to acellular dermal allograft in breast reconstruction. Since allograft is incorporated rather than absorbed, it is preferable in situations where sustained tensile strength is needed. Vicryl® mesh, however, is available for approximately 1/12th the cost of allograft. In our experience, it is a cost effective option when allograft is not available or not required.