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Is Alloderm or Strattice Needed for Implant Reconstruction?

asked 1 year ago by savealotmommy in Indiana
Latest answer by Otto Joseph Placik, MD
Question viewed 1,254 times
Tags: drainage, mastectomy, strattice

I recently had a prophylactic mastectomy and developed a rather odd complication of persistant drainage with alloderm. My skin would open and drain. I did not have an infection and was tested multiple times. I even visted a wound clinic and had numerous lab tests and no infection was found. I did not stop draining until all alloderm was removed. I am a thin woman with not enough tissue to do a transfer for reconstruction my breasts. Can I still get implants without alloderm or strattice?

8 answers to Is Alloderm or Strattice Needed for Implant Reconstruction?

+2

Fluid and redness after Alloderm

I use Alloderm and Strattice regularly for complex reconstructions of the breast and body. Alloderm, especially in the breast, does cause more fluid to build up. This requires that drains be left after surgery for longer than if alloderm was not used. It is not uncommon to need the drains for 2-3 weeks.  Another "unusual complication" is what we call "red breast syndrome." It is a persistent redness that occurs on the breast overlying the alloderm. This is... more
Matthew Schulman, MD

New York Plastic Surgeon
+1

Use of alloderm or strattice in breast reconstruction

Persistent drainage after reconstruction with Acellular dermal matrices such as alloderm is one of the most common reported problems and should be expected. Occasionally it can be associated with redness of the overlying skin and appear consistent with an infection or allergic reaction. Overall, I do believe it has improved the results. One other alternative used with controversially equivalent results to alloderm is the use of vicryl mesh. Discuss these with your surgeon. more
Otto Joseph Placik, MD

Chicago Plastic Surgeon
+1

Issues associated with Breast Reconstruction with Alloderm or Strattice ADM's

Acellular Dermal Matrices such as Alloderm (human) or Strattice (pig) dkin dermis have greatly improved both Cosmetic Breast Surgery and Reconstructive Breast surgery. These biological sheets are used to support the implants (preventing sagging), increase skin thickness over the implants (decreasing implant palpability) and interfere with scar tissue formation (in operationsfor removal of capsular contracture). The problem with these biological sheets is that while the body slowly... more
Peter A. Aldea, MD

Memphis Plastic Surgeon
+1

Reconstruction

Yes.  That is the answer.  Submuscular pockets were used extensively prior to the advent of dermal matrices.  And they worked.
David A. Lickstein, MD

Miami Plastic Surgeon
+1

Breast reconstruction without Alloderm or Strattice

Call me old fashioned, but I believe these substances are overused. We got excellent reeconstruction for years without them, and can still do so most of the time.
Robert T. Buchanan, MD

Highlands Plastic Surgeon
+1

Implant reconstruction without Alloderm

You can absolutely get reconstruction without Alloderm although Alloderm and Strattice is in vogue because it gives a surgeon more control over the position of the implant. However we have done implant reconstruction for decades without Alloderm. Personally I feel this is overused and not without risks such as in your case.
Robin T.W. Yuan, MD

Beverly Hills Plastic Surgeon
+1

Alloderm is very helpful for breast reconstruction

The reason for the alloderm in breast reconstruction is to make an internal bra that supports and covers the implant, but it can be associated with more drainage. Strattice is a stiffer material more suited to revisions rather than primary reconstruction. I would still be in favor of using the alloderm with the next reconstruction.
Richard Baxter, MD

Seattle Plastic Surgeon
+1

Alloderm and drainage

I prefer to use alloderm during breast reconstruction.  If you had it all removed and have healed up presumably from an infection?  You may want to wait 4-6 months to consider restarting again. In that case if you were my patient, I would consider using alloderm again.
Steven Wallach, MD

Manhattan Plastic Surgeon

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