Table 3 Recommendations for the application of synthetic meshes or biological matrices in implant-based breast reconstruction.

Indication and benefits	Synthetic meshes	Biological matrix
X: recommended; XX: preferably recommended; –: not recommended, MRM: modified radical mastectomy
Skin- and nipple-sparing mastectomy	XX	XX
Inherent breast deformities	X	X
Implant-associated breast deformities	X	XX
Implant exchange	XX	XX
Fixation of the pectoralis major muscle	XX	XX
Control of implant position	XX	XX
Implant support	X	XX
Implant coverage	–	XX
Additional soft tissue replacement	–	XX
Implant-based breast reconstruction after MRM	–	XX
Breast reconstruction after radiotherapy	–	X
Delayed immediate breast reconstruction (mastectomy with expander → radiation → final implant exchange)	–	XX
Decreased frequency of capsular contraction	unknown	unknown