The Evolution in Biologic Matrices

Exa-flex is derived from naturally occurring bilayer pericardium, sourced from biosecure animals of under 20 months1.

Our Secret is the Bilayer Structure

Exa-flex is designed solely for use in Reconstructive Breast Surgery and manufactured using a proprietary process which does not affect the biological properties of the pericardium.

Exa-flex guarantees rapid integration times with intrinsic cellular growth2. Each layer performs a specific task in the integration process:

  • The fibrous layer is highly porous, allowing cells to enter the matrix and initiate cell migration; this supports the cytokines and growth factors for optimal integration and early angiogenesis3.
  • The compact layer provides structural support – it is rapidly repopulated by fibroblasts and VEGF, and it shows no accumulation of inflammatory or giant cells4.

The Three phases of integration

The bilayer membrane undergoes regeneration of connective tissue in 3 phases5.

  1. After the matrix has been implanted, blood platelets enter the matrix and are activated by the collagen structure. This starts the release of growth factors and initiates cell migration.
  2. Fibroblasts synthesise collagen, triggering the growth of new blood vessels to meet metabolic demand.
  3. This phase is marked by the proliferation of cells which will encourage the growth of new tissue. The remodelling phase starts, synthesising the collagen into an integrated living tissue.

Pro-Heal Element

The cell-friendly manufacturing method preserves the active components of the repair process such as: proteoglycans, hyaluronic acid, fibronectin, elastin and native collagen with the membrane6.
These elements provide a natural bioactive environment for regeneration whilst maintaining biomechanical properties. They also reduce the amount of biological mass needed7 (up to 50% less than dermal matrices) and promote integration, even with poor blood supply.

Exa-flex Pocket

Exa-flex offers a unique suture-less pre-pectoral Pocket.

The implant is cleverly enclosed/wrapped with Exa-flex, conforming to the shape of the implant in under 60 seconds, which significantly reduces implant exposure time. Exa-flex offers suture-less fixation to the chest wall and skin flap due to the rapid integration of tissue into the outer fibrous layer of the matrix, thereby reducing post-operative pain and theatre time.

Exa-flex Implant-wrapped
Exa-flex image6

The bovine pericardial patch in breast reconstruction: A case report
Semprini GI, Cattin F, De Biasio F, Cedolini C, Parodi PC

Acellular bovine pericardium in implant-based breast reconstruction: A systematic review of the literature
Uppara Mallikarjuna, Minahil Mujahid, Richard Pilkington, M Shaheer, Pervaz Mujahid

Biological and synthetic mesh use in breast reconstructive surgery: A literature review
Hugh Logan Ellis, Oluwatosin Asaolu, Vivien Nebo, Abdul Kasemi

Impact on quality of life with breast reconstructive surgery after mastectomy for breast cancer
Trejo-Ochoa JLI, Maffuz-Aziz A, Said-Lemus FM, Dominguez-Reyes CA, Hernandez-Hernandez B, Villegas-Carlos F, Rodriguez-Cuevas S

Immediate breast reconstruction does not increase postmastectomy pain
Julia R. Henderson, Amy Tao, Cliona C. Kirwan, Lester Barr