Is Alloderm or Strattice Needed for Implant Reconstruction?
Doctor Answers (9)
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 probably an inflammatory reaction as the alloderm incorporates. It looks like an infection, but there is no bacteria. It resolves on its own but can take several weeks.
Regardless of what really happened to you, it is possible to reconstruct a breast without alloderm. Remember, alloderm has only been widely used for the past 5-7 years.....but we have been doing breast reconstruction much much longer. Alloderm may help in certain situtations and may help prevent some common problems, but it is not necessary if you have had a bad reaction.
Is an acellular dermal matrix necessary for implant reconstruction?
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.
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Issues associated with Breast Reconstruction with Alloderm or Strattice ADM's
Yes. That is the answer. Submuscular pockets were used extensively prior to the advent of dermal matrices. And they worked.
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.
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.
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.
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