Advanced Biomedical Concept · The Evidence

The Matrix That Regenerates

ExaShape is a bilayer bovine-pericardium biological matrix engineered to do more than reinforce — it is designed to reactivate the body's own tissue. Explore the published evidence behind matrix-supported prepectoral breast reconstruction, sourced and cited.

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Interactive · Clinical Evidence Explorer

The Numbers, With Their Sources

Select an outcome to explore the published data behind implant-based breast reconstruction. Every bar carries its own citation. Use it as a starting point for the primary literature — never as a substitute for it.

⚠ Different studies — not a head-to-head trial

The figures below come from separate published studies with different cohorts, complication definitions, follow-up periods and surgical settings. They give indicative context — not a controlled comparison. A lower number in one study does not, on its own, prove one material or technique is superior. Read each figure in the context of its full publication.

Complication Rates by Series

Reported rate · lower is better

Bovine pericardium / ABC series ADM / other material Synthetic mesh
The Science · How It Works

From Scaffold to Living Tissue

A biological matrix is not inert packing. ExaShape's bilayer bovine-pericardium architecture is designed to be colonised — turning an implanted scaffold into the patient's own regenerated tissue.

Phase 01

Bilayer Scaffold

A smooth structural face and a porous regenerative face give the implant mechanical support while inviting cellular in-growth from the surrounding tissue.

Phase 02

Fibroblast Reactivation

The matrix is designed to recruit and reactivate fibroblasts, the cells responsible for laying down new collagen and rebuilding a natural tissue framework.

Phase 03

Tissue Regeneration

As new collagen is deposited and vascularised, the scaffold is gradually integrated — the aim is durable, patient-own tissue rather than a permanent foreign body.

Mechanism of action as described in ABC device literature. Individual clinical outcomes vary; see the biological matrix guide and the device Instructions for Use for full detail.

The Record · 2007 → 2025

Two Decades of Evidence

The publications that shaped modern prepectoral, biological-matrix and fat-grafting practice — including the device-specific bovine-pericardium series. Scroll the rail.

2007
Coleman & Saboeiro revisit fat grafting to the breast, establishing safety and technique.
2016
Gschwantler-Kaulich randomise ADM vs synthetic mesh — ~31% complications in both arms.
2017
Vidya, Masià publish foundational prepectoral reconstruction series.
2020
The iBAG multicentre study reports 1,450 prepectoral ADM procedures across 30 centres.
2022
Mazzocchi et al. report an early ExaShape bovine-pericardium series (n=21).
2023
Zhu & Liu publish an ADM meta-analysis pooling 2,667 patients.
2024
De Vita et al. report a prepectoral DTI bovine-pericardium series (n=65).
2025
Casella et al. (STEP) add device-specific bovine-pericardium safety data.

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References

  1. De Vita R, et al. Prepectoral direct-to-implant breast reconstruction with acellular bovine pericardium matrix. Clin Breast Cancer. 2024. DOI: 10.1016/j.clbc.2024.06.004.
  2. Zhu L, Liu P. Acellular dermal matrix in implant-based breast reconstruction: a meta-analysis. Aesthetic Plast Surg. 2023. DOI: 10.1007/s00266-023-03296-0.
  3. Masià J, et al. The iBAG multicentre study of prepectoral ADM reconstruction. J Surg Oncol. 2020. DOI: 10.1002/jso.26073.
  4. Casella D, et al. STEP: bovine pericardium in prepectoral reconstruction. J Clin Med. 2025. DOI: 10.3390/jcm14176296.
  5. Vidya R, Masià J, Berna G, et al. Prepectoral implant-based reconstruction — foundational series. Breast J. 2017. DOI: 10.1111/tbj.12810.
  6. Gschwantler-Kaulich D, et al. ADM vs synthetic mesh: a randomised comparison. Eur J Surg Oncol. 2016. DOI: 10.1016/j.ejso.2016.02.007.
  7. Coleman SR, Saboeiro AP. Fat grafting to the breast revisited. Plast Reconstr Surg. 2007;119(3):775–785. DOI: 10.1097/01.prs.0000252001.59152.8a.
  8. Mazzocchi M, et al. Bovine pericardium acellular matrix (ExaShape) in implant-based breast reconstruction. Plast Reconstr Regen Surg. 2022. DOI: 10.57604/PRRS-064.
Educational use only. This section summarises published literature for information and education. It is not clinical advice, not a promotional performance claim for any device, and not a substitute for the relevant Instructions for Use or a qualified clinician's judgement. Figures are drawn from separate studies with differing methods and are indicative, not head-to-head. Reviewed by Advanced Biomedical Concept Medical Team; last reviewed 2026-09-22.