Devils in the Details: Breast Pearls from the Experts | Belgium, United States, Argentina | Global Partner Webinar Series-Devils in the Details: Breast Pearls from the Experts | Belgium, United States, Argentina

Devils in the Details: Breast Pearls from the Experts | Belgium, United States, Argentina | Global Partner Webinar Series

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Video Transcription

Video Summary

The webinar opened with Dr. Horacio Meyer introducing the ASPS Global Partner program, which now includes 56 national plastic surgery societies across all continents. He highlighted member benefits such as access to PRS journals, international scholar and visiting professor programs, resident and young surgeon forums, and upcoming ASPS meetings in Houston.<br /><br />The main presentation by Dr. Mark Clements focused on direct-to-implant (DTI) breast reconstruction in challenging patients. He emphasized that successful reconstruction depends on small technical details: flap perfusion, pocket control, restoring anatomic boundaries, and preventing dead space. He described a shift in his practice toward 100% prepectoral reconstruction, selective use of ADM or P4HB mesh, and highly cohesive, low-inflammatory implants. He also discussed approaches for radiated, ptotic, and non-ideal patients, including the VIPER technique, use of the latissimus flap in irradiated cases, and the importance of aborting DTI when flap perfusion is poor.<br /><br />Dr. Mustafa Hamdi then presented his long experience with “inner bra” mastopexy. He explained that traditional mastopexy often fails over time because of bottoming out and loss of shape. His approach evolved from permanent mesh and silicone sling systems toward scaffold-based support, including Galaflex/P4HB. He described techniques that suspend the breast tissue, reinforce the lower pole, improve projection, and reduce tension on skin closure. He also discussed when to use mesh, how to manage complications conservatively, and the role of fat grafting for upper-pole contour.<br /><br />The session ended with a Q&A on implant choice, capsular contracture, mesh use, and revision strategies, followed by closing thanks and an invitation to future ASPS events.

Keywords

ASPS Global Partner program

breast reconstruction

direct-to-implant

prepectoral reconstruction

flap perfusion

ADM mesh

P4HB mesh

mastopexy

inner bra

irradiated patients

fat grafting

capsular contracture