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

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 (R) Bra in IBBR and compares its postoperative complication risk with that of porcine acellular dermal matrix (ADM) and SERAGYN (R) BR. Methods The literature review was performed via PRISMA criteria, 23 studies met the inclusion criteria for the TiLOOP (R) 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 (R) 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 (R) Bra. However, the meta-analysis showed that the TiLOOP (R) 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 (R) Bra group had a significantly lower seroma rate compared to the SERAGYN (R) BR group, while the other outcome indicators were similar between the two groups. Conclusion TiLOOP (R) Bra has become increasingly popular in IBBR in recent years. This review and meta-analysis support the favorable safety profile of TiLOOP (R) Bra reported in the current literature. The meta-analysis revealed that TiLOOP (R) Bra has better safety than ADM and a comparable risk of complications compared to SERAGYN (R) 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.