TiLOOP® Bra

Implantation

TiLOOP® Bra is available in three different version to support smaller breasts (<200 g), medium-sized breasts (<350 g) and larger breasts (<500 g); the choice of version is at the discretion of the implanting physician.

Procedure

1. Separate the pectoral muscle from the caudal end toward the sternal edge from the thoracic wall.
2. Fix the TiLOOP® Bra mesh implant to the caudal and lateral end of the pectoral muscle with a continuous suture. When fixing the TiLOOP® Bra mesh implant to the muscle edge, care must be taken regarding the flexible and elastic orientation of the mesh fabric to permit the post-operative stretching of the caudolateral part of the reconstructed breast.
3. Stich the lower part of the TiLOOP® Bra mesh implant to the inframammary fold with single stitches using monofilament sutures. It is highly recommended to have patients wear a support bra post-operatively in addition to a Stuttgart belt in order to support and improve post-operative stretching in the caudolateral breast pole area.

Titanisation

Chemical vapour deposition (CVD) is a process for the metallisation of complex components while at the same time achieving strong bonds. However, as this process involves temperatures in excess of 150°C, it is not an option for many prosthetic materials which would not be shape retentive at such temperatures (e.g. polypropylene).

For that reason, the titanisation of plastic implants takes place at low temperatures using a special plasma-coating process known as PACVD (plasma-activated chemical vapour deposition).

Plasma is the term used for an excited (ionised) gas. In that stage, atoms/molecules are highly energetic. However, plasma is not hot. In everyday life, we are familiar with plasma in fluorescent tubes. The electrically charged gas components emit light as the result of their highly energetic state, but the fluorescent tube remains cold.

In the titanisation process, gaseous titanium is introduced into the coating chamber as a precursor. By adding energy in form of plasma, the precursor is split into individual ionised atoms. These ionised titanium atoms have free electrons at their surfaces.

In addition to the precursor, the plasma also excites the surfaces of the plastic implants with the result that their surfaces also have free electrons. The ionised titanium atoms come into contact with the ionised surface of the implant resulting in the formation of covalent bonds with the free electrons. Covalent bonds are seen as the strongest of chemical bonds; the titanium is thus almost permanently bonded to the plastic.

This process creates a composite material whose surface is coated with an ultra-thin, approx. 30–50 nm (1 nanometre = 1 millionth of a millimetre), highly biocompatible layer of titanium. The coating is so thin that it appears to be transparent and is also highly flexible.

Because the titanium precursor is introduced in gaseous form, it reaches all parts of the plastic implant. As the result, the entire surface, including gaps in between complex shapes, is completely and evenly titanised.