Is mesh with a breast implant safe? I’ve read the mesh can be toxic and cause infection easier.

Thank you for the question. The use of acellular dermal matrix or biosynthetic mesh may be very helpful when it comes to providing additional support for breast implants and/or breast tissue.  I find this material very helpful in cases where patients have recurrent implant displacement concerns and/or significant loss of skin/tissue strength. Whether or not it is "necessary" can only be determined after careful evaluation of a specific patient's history and physical examination;  advice from well experienced board-certified plastic surgeons will be helpful in the decision-making process.
Acellular dermal matrix is a biologic implant that carries the ability to become integrated into native tissue. It is made by taking a full thickness section of skin from a donor source (his human, porcine, or bovine in origin).   These materials may be helpful as a supportive matrix, help with the breast implant displacement/malposition,  provide additional support where a capsule repair (capsulorraphy)  is carried out ( such as cases involving bottoming out, lateral displacement, symmastia) etc.  I have also found the material to be very helpful when it comes to treating severe breast implant rippling/palpability concerns.  Furthermore, the acellular dermal matrix is very helpful when it comes to treating challenging/recurrent cases of breast implant encapsulation.Best wishes!

I wrote the chapter on breast augmentation revision with Strattice and other materials and techniques in Annals of Plastic Surgery with other surgeons and professors at Harvard.  However, I certainly do not use it in every revision.  I use it in probably 1 out of every 20 revisions for very specific indications in which there is an intrinsic laxity of tissues and poor local tissue support.  This will largely be a function of the indication for the usage of Strattice.  If it is used in recurrent capsular contracture, the concern would be different than if it were used to help in pocket reconstruction or prevention of bottoming out.Kenneth Hughes, MD, Board Certified Plastic SurgeonLos Angeles, CA

Hello and thank you for your question.  I have used mesh in many revision breast surgery cases for bottoming out or implant malposition.  Galaflex is the mesh I prefer and is extremely safe.  There is a mesh many surgeons used to use called Seri Scaffold which was associated with infections and it is no longer used for this reason. I recommend
that you seek consultation with a qualified board-certified plastic surgeon who
can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.  FACS
Harvard-trained plastic surgeon