TILOOP mesh in immediate prepectoral breast reconstruction via single-port endoscopic axillary approach: a study in early- and mid-stage breast cancer patients.

[BACKGROUND] Prepectoral implant-based breast reconstruction (BR) via single-port endoscopic axillary approach reduces visible scarring and incision-related complications. TILOOP mesh may improve implant support and aesthetics, but its added value remains uncertain. This study evaluated outcomes, complications, and patient satisfaction with mesh use.

[METHODS] A retrospective cohort of 383 patients (165 mesh 218 no-mesh) undergoing immediate prepectoral BR via single-port endoscopy [2020-2022] was analyzed. Outcomes included surgical parameters, complications at 30 days/12 months, oncological results at 36 months, and Breast Reconstruction Evaluation and Satisfaction Questionnaire (BREAST-Q) satisfaction.

[RESULTS] Baseline features were balanced. The mesh group showed slightly lower mean postoperative pain scores and higher breast satisfaction scores; however, these differences did not reach statistical significance (P>0.05). Mesh use was associated with greater blood loss (98.1±62.2 91.2±42.2 mL, P<0.05) and longer hospitalization (8.4±4.1 5.6±2.8 days, P<0.05). There were no significant differences in complication rates, psychological well-being, or physical function between groups. Subgroup analysis indicated that patients with larger breast volumes tended to derive greater aesthetic and structural benefit from mesh use, though these findings should be interpreted cautiously.

[CONCLUSIONS] Mesh-assisted prepectoral reconstruction demonstrated comparable safety outcomes to non-mesh reconstruction, with a trend toward reduced postoperative pain and improved breast satisfaction but without statistically significant differences. Mesh use was associated with higher blood loss and longer hospitalization. Overall, mesh application should be individualized based on breast volume, reconstructive goals, and patient-specific factors.