Implant Based Breast Reconstruction Using a Titanium-Coated Polypropylene Mesh (TiLOOP® Bra): A Systematic Review and Meta-analysis

• Published in: Aesthetic plastic surgery 2024-03, Vol.48 (5), p.925-935
• Main Authors: Zhang, Tingjian, Ye, Jing, Tian, Tian
• Format: Article
• Language: English
• Subjects: Acellular Dermis; Animals; Breast Implantation; Breast Implants; Breast Neoplasms - surgery; Breasts; Female; Humans; Mammaplasty; Medicine; Medicine & Public Health; Meta-analysis; Otorhinolaryngology; Patient satisfaction; Plastic Surgery; Polypropylenes; Postoperative Complications - epidemiology; Postoperative Complications - prevention & control; Retrospective Studies; Review; Seroma; Surgical Mesh; Swine; Titanium; Treatment Outcome
• ISSN: 0364-216X; 1432-5241; 1432-5241
• DOI: 10.1007/s00266-023-03500-1

Background Implant-based breast reconstruction (IBBR) can be performed using a variety of biological and synthetic meshes. However, there has yet to be a consensus on the optimal mesh. This study investigates the safety and patient satisfaction of using TiLOOP® Bra in IBBR and compares its postoperative complication risk with that of porcine acellular dermal matrix (ADM) and SERAGYN® BR. Methods The literature review was performed via PRISMA criteria, 23 studies met the inclusion criteria for the TiLOOP® Bra review, and 5 studies met the inclusion criteria for the meta-analysis. Patient characteristics and per-breast complications were collected. Data were analyzed using Cochrane RevMan and IBM SPSS. Results In 3175 breasts of 2685 patients that underwent IBBR using TiLOOP® Bra, rippling was observed as the most common complication, followed by seroma and capsular contracture. No significant difference in the overall complication rate between pre- and sub-pectoral IBBR using TiLOOP® Bra. However, the meta-analysis showed that the TiLOOP® Bra group had significantly lower odds of implant loss, seroma, wound dehiscence, and the need for reoperation or hospitalization than the ADM group. Additionally, the TiLOOP® Bra group had a significantly lower seroma rate compared to the SERAGYN® BR group, while the other outcome indicators were similar between the two groups. Conclusion TiLOOP® Bra has become increasingly popular in IBBR in recent years. This review and meta-analysis support the favorable safety profile of TiLOOP® Bra reported in the current literature. The meta-analysis revealed that TiLOOP® Bra has better safety than ADM and a comparable risk of complications compared to SERAGYN® BR. However, as most studies had low levels of evidence, further investigations are necessary. Level of Evidence III This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .