Follow a single ExaShape matrix from the moment it is placed to the moment it becomes patient-specific collagen.

A biological matrix is not a fixed object. From the day it is implanted, an ExaShape membrane begins a transformation that ends with it being replaced, cell by cell and vessel by vessel, by the patient’s own tissue. Understanding that timeline is understanding the device. Here is the arc, stage by stage.

Day 0: Implantation

The matrix goes in as bilayer bovine pericardium: a compact layer against the implant, a porous layer facing the tissue. It is non-crosslinked, which means the native collagen architecture is intact and legible to the body from the first hour. Nothing about it is inert. The clock starts immediately.

The first days: Early inflammation

The initial response is dominated by M2 macrophages, the population associated with tissue repair rather than rejection. Growth factors are released to activate fibroblasts, priming the site for construction. Because ExaShape carries a low biological mass, this inflammatory phase stays minimal, which is associated with a reduced risk of seroma and oedema. The body is not fighting the matrix. It is preparing to build on it.

Weeks to early months: Neoangiogenesis

New blood vessels begin to grow inside the porous layer and then progressively into the compact layer. This vascular ingrowth drives rapid fibroblast repopulation, and because the porous layer is permeable, it begins earlier than a denser material would allow, which is associated with a reduced risk of necrosis. Progressive neovascularization within the matrix has been observed across a 12-month period (Varvaras D, et al. St. Gallen 2023). This is the stage where a device starts becoming tissue.

The middle months: Collagen formation

Now the repopulating fibroblasts do their work. They produce patient-specific collagen, filling the porous layer first and then the compact layer. As native collagen is laid down, ExaShape integrates firmly with the surrounding tissue and turns flexible and biologically active. Throughout, the response stays regulated, with controlled periprosthetic remodelling (Bernardini R, et al. J Biomed Mater Res. 2020). The membrane is no longer a separate layer sitting in the pocket. It is becoming part of the patient.

Toward 12 months: Remodelling

In the final stage, collagenases enzymatically degrade the original matrix, opening spaces that are progressively replaced by organised collagen and new blood vessels. The tissue that results is elastic, biologically active, and thicker than the original membrane. What began as a processed pericardial sheet finishes as living, vascularised, patient-specific tissue.

Why the timeline is the message

Every claim ExaShape makes lives somewhere on this arc. Reduced seroma risk belongs to the inflammation stage. Reduced necrosis risk belongs to neoangiogenesis. Firm integration belongs to collagen formation. Durable, elastic support belongs to remodelling. The device is not defined by a single moment but by a predictable trajectory, and that trajectory is documented in real-world clinical data at 12 months and, in the De Vita series, across a mean follow-up of 21.3 months (De Vita R, et al. Clinical Breast Cancer. 2024).

A matrix you can follow through time is a matrix you can plan around.

Placed as a membrane. Integrated as living tissue. On a timeline you can trace.

Watch the mode of action unfold on the ExaShape line page, or request a demo.

Scientific references

  1. Varvaras D, et al. Use of Acellular Pericardial Biological Mesh for Prepectoral and Dual Plane. St. Gallen 2023.
  2. Bernardini R, et al. J Biomed Mater Res. 2020.
  3. De Vita R, et al. A Pericardium Bovine Matrix Pocket in DTI Prepectoral Breast Reconstruction. Clinical Breast Cancer. 2024.

Images for illustrative purposes only. For Healthcare Professionals Only. ExaShape is CE marked per EU MDR 2017/745.

Important information This article is general education, not medical advice. Tap to read the full medical, regulatory & legal notice.

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Last reviewed: July 2, 2026.