A sheet of mesh the size of your palm. Two years, then gone, collagen left behind. I put one in nearly every breast operation I do.
Every Lift, Every Reduction, Every Augmentation
“I actually recommend internal mesh support on all patients, on breast lifts, breast reductions, and breast augmentations.”
“In a breast lift and a breast reduction, it actually helps reshape the breast tissue and support it, just like a push-up bra, to gain more upper pole fullness and avoid bottoming out and lateral displacement.”
“Of course, this is a recommendation, and some patients decline using the mesh, with the knowledge that they will not have that added support.”
Two Years
“The mesh supports the tissues for a period of up to two years. As it dissolves, it leaves behind collagen deposits, so the support remains there even well after the mesh has gone.”
“I use two main types of mesh. GalaFLEX, including GalaFLEX LITE, which is lighter, and DuraSorb mesh. The choice depends on each patient and what we want to achieve.”
The Worry
“We have not had a single case of infected mesh when we have used DuraSorb or GalaFLEX, and we have never had to remove the mesh.”
My practice. Not a study.
“We have been using internal mesh support for breast reconstruction for more than 20 years, and these techniques have been incorporated into aesthetic surgery. There are always risks associated with using any implanted material. In my experience with GalaFLEX and DuraSorb, I have seen significantly fewer complications, if any, compared to other mesh systems and dermal grafts. A lot of the symptoms alleged to have resulted from the use of mesh can actually occur when we don’t use a mesh at all.”
The Fact Nobody Tells You
“There have been cases where the mesh is palpable, and we have decreased this risk by changing to GalaFLEX LITE, which is thinner and less palpable, and to DuraSorb. The fact that the mesh can sometimes be palpated is a sign that the patient has very thin tissues, through which the mesh can be felt. If we had not used a mesh in these cases, we would probably be able to palpate the implant or visually see rippling. In these cases, the mesh is actually helping to thicken the skin and tissue envelope, and as the mesh dissolves over time, that palpability disappears.”
Feel the mesh, or feel the implant. That is the choice thin tissue gives you. Rippling is the version without the mesh.
“It is important to also realize that there are risks involved with not using a mesh. These risks include rippling, implant palpability, and implant displacement.”
| She asks | The answer |
|---|---|
| Do I need it? | I recommend it on every lift, reduction and augmentation; declining is her call |
| How long is it in there? | Up to two years, then collagen in its place |
| What if I can feel it? | Thin tissue; without the mesh she would feel the implant |
| Does it change recovery? | No, and not the drain either |
Contracture
“In all actuality, there has been increasing evidence that the use of GalaFLEX and DuraSorb can decrease the risk of capsular contracture or capsular contracture recurrence. In many cases of recurrent capsular contracture, we are actually recommending a complete wrap of the implant with GalaFLEX or DuraSorb mesh to decrease the risk of recurrence.”
More on that in the capsular contracture revision read.
Recovery
“When we use a mesh, it does not change recovery time, it does not change whether we use a drain or not, and it does not affect how long the drain stays if we do decide to use one.”
The operation where the mesh earns its keep is the auto augmentation lift. The surgical read with the cost ranges is on agulloplasticsurgery.com; the patient version is on the Southwest Plastic Surgery post.
Why Choose Dr. Agullo
Double board-certified, by the American Board of Plastic Surgery and the American Board of Surgery. Mayo Clinic plastic surgery fellowship. Clinical Associate Professor of Plastic Surgery at Texas Tech University Health Sciences Center. Castle Connolly Top Doctor for 13 consecutive years.
Ready to Talk?
Ask to hold the mesh. Then decide. (915) 590-7900, text 1-866-814-0038, or book at agulloplasticsurgery.com/appointments. #StayBeautiful
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