Tissue response to the use of synthetic and biological meshes in implant-based breast surgery: A histomorphological case-series of six patients.

Despite the widespread use of mesh in implant-based breast surgery, histologic characterization of mesh-associated tissue responses remains limited. This retrospective case series examines the histologic features of 6 tissue biopsy specimens, which feature explanted mesh from 6 patients who underwent revision breast surgery. Revision procedures occurred between 4 and 36 months after initial implantation of the mesh. All tissue samples underwent objective scoring across predefined histologic categories and descriptive pathologic assessment. Evaluation of the specimens revealed immune cell infiltration predominantly composed of macrophages, an acute inflammatory response and foreign body reaction that diminished progressively over time, and organized deposition of an extracellular collagen matrix without fibrosis of the tissue at later time points. These histologic findings may be helpful considerations in the overall evaluation of mesh performance.