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.
- 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.
- Fibroblasts synthesise collagen, triggering the growth of new blood vessels to meet metabolic demand.
- 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.


*1-7
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