Veritas in Immediate Implant-based Breast Reconstruction Is Associated with Higher Complications Compared with TiLOOP

Abstract

Background: Biologic and synthetic meshes are used in immediate implant-based breast reconstruction for coverage of the lower pole of the implant. This study aimed to compare outcomes of Veritas with TiLOOP bra (TiLOOP group [TG]). Methods: Retrospective study of skin- and nipple-sparing mastectomies in patients who underwent an implant-based reconstruction using either Veritas or TiLOOP bra between January 2014 and December 2016 was performed. Results: Thirty-six reconstructions (22 unilateral, 7 bilateral) using the Veritas mesh and 179 breast reconstructions (61 unilateral, 59 bilateral) using TiLOOP bra were identified. The Veritas group (VG) showed a higher rate of postoperative complications compared with the TG (VG = 54% versus TG = 14%, P < 0.01%), including higher rates of seroma, nonintegration of mesh (VG = 51.4% versus TG = 1.6%, P < 0.01), implant rotation (VG = 16.2% versus TG = 1.6%, P < 0.01), infection (VG = 18.9% versus TG = 2.1%, P < 0.01), and wound breakdown (VG = 10.8% versus TG = 0.5%, P < 0.01). The VG also had a higher rate of major interventions (VG = 35.1% versus TG = 7.8%, P < 0.01) and minor interventions (VG = 18.9% versus TG = 2.2%, P < 0.01) compared with TG, including a higher rate of implant loss and unplanned return to theater. Conclusions: Veritas mesh was associated with a significantly higher rate of postoperative complications compared with TiLOOP bra. Our data strongly question the safety profile of Veritas in implant-based breast reconstruction. Further studies in this area are warranted.