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Alimi et al. Plast Aesthet Res 2020;7:5 Plastic and
DOI: 10.20517/2347-9264.2019.39 Aesthetic Research

Review Open Access

Mesh and plane selection: a summary of options
and outcomes

Yewande Alimi , Chamilka Merle , Michael Sosin , Marielle Mahan , Parag Bhanot 1
1
1
2
3
1 Department of Surgery, Medstar Georgetown University Hospital, Washington, DC 20007, USA.
2 NYU Langone Health, The Hansjörg Wyss Department of Plastic Surgery, New York, NY 10016, USA.
3 Department of Medicine, Medstar Washington Hospital Center, Washington, DC 20010, USA.
Correspondence to: Dr. Parag Bhanot, Department of Surgery, Medstar Georgetown University Hospital, 3800 Reservoir Rd NW
Washington, DC 20007, USA. E-mail: PXB129@gunet.georgetown.edu

How to cite this article: Alimi Y, Merle C, Sosin M, Mahan M, Bhanot P. Mesh and plane selection: a summary of options and outcomes.
Plast Aesthet Res 2020;7:5. http://dx.doi.org/10.20517/2347-9264.2019.39

Received: 15 Oct 2019 First Decision: 9 Dec 2019 Revised: 1 Jan 2020 Accepted: 15 Jan 2020 Published: 20 Feb 2020

Science Editor: Sahil Kuldip Kapur Copy Editor: Jing-Wen Zhang Production Editor: Tian Zhang

Abstract

Abdominal wall reconstruction is a relevant and important topic not only in plastic and reconstructive surgery, but in
the practice of general surgeons. The ideal anatomic location for mesh placement during the repair of ventral hernias
has been debated; however, the most common anatomic locations include onlay, inlay, sublay-retromuscular, sublay-
preperitoneal, and sublay-intraperitoneal techniques, as defined by the European Hernia Society. Additionally, the
availability of numerous synthetic and biologic meshes on the market provides for several options for the practicing
surgeon. In this review, we provide a summary of the available literature of both the ideal mesh plane and the appropriate
opportunities to use both synthetic and biologic meshes.

Keywords: Ventral hernia repair, mesh, underlay, onlay, inlay, sublay, synthetic mesh, biologic mesh

INTRODUCTION
Defects in the anterior abdominal wall with a resulting ill-defined bulge are both aesthetically displeasing
and are associated with musculoskeletal and gastrointestinal dysfunction. The field of abdominal
wall reconstruction is a complex topic that comprises a large practice approached by both plastic and
reconstructive surgeons and general surgeons. Over one-quarter of all individuals have or will develop
[1]
a hernia in their lifetime . Although the true incidence of incisional hernias is difficult to ascertain,

© The Author(s) 2020. Open Access This article is licensed under a Creative Commons Attribution 4.0
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