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Is Alloderm in Combination with an Implant Better to Reach a More Natural Looking Breast?

I will undergo a revision of a breastreconstruction bilateral in the Netherlands. The current size is too small for my chest and skinpocket. I have a relatively thin skin. Is alloderm a safe and best esthetic option to use to have a better cosmetic outcome?

Doctor Answers (7)

Acellular dermal matrix and breast reconstruction - more natural looking?

+1

Thank you for your question!  The use of the acellular dermal matrix has grown in its applications and use in plastic & reconstructive procedures, and growing. It has truly been a remarkable addition for breast reconstruction.

The acellular dermal matrix is a tissue that is specially-prepared, which comes from cadaveric skin. It is placed on the inside, not on your skin.  It has been processed in such a way that the basement membrane and cellular matrix remain intact, while removing all other cellular components that may lead to both rejection and infection. Packages as a sterile tissue product, due to its preparation, the chance of acquiring viruses and such is nearly absent.

Its applications for breast reconstruction alone include its use in tissue expander/implant reconstruction, to act as a "hammock" at the inferior portion of the breast for which the implant lies within. This creates a natural "sling" which mimics the ptosis (sag) of the breast, while supporting it in place. By suturing this matrix to its exact position of the breast margins, the plastic surgeon is able to precisely recreate an excellent contour for your breast, especially at the inferior, medial, and lateral positions. This also minimizes migration of the implant, as sometimes seen with "bottoming out" inferiorly or its displacement into the axilla (armpit). In addition to its increased aesthetic results, the acellular dermal matrix provides additional coverage over your implant. This is especially useful in those instances of dehiscence (your incision opening up), thus protecting the implant from exposure, and threatening its necessity for removal. Furthermore, in cases where the overlying mastectomy flaps are thin or damaged, leading to partial flap necrosis, the tissue matrix again provides a coverage over your implant, which can heal over time or a graft placed over the are or simply closed. Lastly, the additional coverage lessens implant visibility and palpability and is a great adjunct for revisionary breast surgery. The use of this matrix, along with the advantages listed above, has reduced the time of the reconstructive portion of the procedure as well. There is less pectoralis muscle retraction and eliminates the need to raise any other surrounding muscles in order to achieve complete implant coverage.


Scottsdale Plastic Surgeon
5.0 out of 5 stars 12 reviews

Using Alloderm in breast reconstruction

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Using Alloderm or any other acellular dermal matrix can aid in breast reconstruction by minimizing the need to lift additional muscles to cover the implant and supporting the lower skin flap. In addition the give of the matrix allows for preferential expansion in the lower pole of the breast. This does allow for an improved cosmetic result. 

Asaad H. Samra, MD
New Jersey Plastic Surgeon
5.0 out of 5 stars 23 reviews

Alloderm for more natural looking breasts

+1

Thanks for your question.  Actually there are several options when it comes to using tissue matrix materials to aidin breast reconstruction.  The alloderm will aid in the lower pole of the breast, helping anchor the implants in place, and making the tissue slightly thicker.  Once integrated it will be hard to tell what is native tissue vs. alloderm.  One of the concerns with using alloderm is that it will stretch over time, which normall in breast reconstruction is necessary.  To much might not be beneficial.  I tend to use other tissue matrices such as Surgimend, which is stronger and is also fenestrated.  This allow you to only have one drain per side instead of two normally seen with alloderm.  Photos and a physical exam would aid in giving further recommendations.  Good luck in your endeavors.

 

Robert Kratschmer, MD

Robert Kratschmer, MD
Houston Plastic Surgeon
4.5 out of 5 stars 10 reviews

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Yes alloderm can help in revision breast reconstruction surgery

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The use of alloderm can be helpful in revision surgery to soften wrinkles as well as provide support of the breast implant used.

Robert Whitfield, MD, FACS
Austin Plastic Surgeon
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Alloderm is an effective option for revision breast surgery

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Alloderm forms a sort of living internal bra that can help support and cover breast implants. For thin patients needing revision breast surgery it can be especially useful, though I cannot comment on your specific case without more information. There are other products such as Strattice that also work well.

Richard Baxter, MD
Seattle Plastic Surgeon
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Alloderm for nautral breast appearance

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Great question -

Alloderm is a "dermal matrix" which has the structural elements of a part of your skin called the dermis but has had the cells removed.

 

This dermal matrix can be used for reinforcing natural tissue in hernia repair or as a way to create a thicker tissue coverage over implants.  It can be used to reduce implant palpability or reduce implant rippling.  It can also be used to lower the recurrence of capsular contracture.

 

In breast reconstruction it is very commonly used during implant reconstruction to create a natural inferior pole and to decrease the time for tissue expansion.

 

You should review your concerns for breast enhancement with your plastic surgeon to see if this something that may address a specific problem you have.  In my San Francisco area practice we use dermal matrix for all of the problems listed above.

 

I hope this helps!

Steven H. Williams, MD
San Francisco Plastic Surgeon
4.5 out of 5 stars 28 reviews

Is Alloderm in Combination with an Implant Better to Reach a More Natural Looking Breast?

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It is difficult to answer this question without photographs

There are new options now available such as absorbable synthetic mesh ,fat derived  Stem cell injections, and PRP

Hilton Becker, MD
Boca Raton Plastic Surgeon
5.0 out of 5 stars 6 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.