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Alloderm or Strattrice - Which is Better for Breast Reconstruction?

What determines if a surgeon uses Alloderm or Strattice for breast reconstruction? Alloderm was used in my reconstruction and I had persistant draining issues until it was removed. I am reluctant to try alloderm again and I was wondering if Strattrice would be an option or if it too had the potential for causing excess drainage.

Doctor Answers (8)

AlloDerm vs Strattice in breast reconstruction

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AlloDerm and Strattice are both brand names of a group of products called Acellular Dermal Matrix (ADM). They are used as a scaffold to allow your own tissue to grow in and become incorporated into your body. AlloDerm comes from human skin while Strattice comes from pig skin, both are provided by the same company. All ADM products are processed to eliminate any living cells and prevent diseases from being passed.

Good head to head studies are not available to compare AlloDerm directly to Strattic in breast reconstruction. The surgeon may choose the product based on personal experience, product cost, easy of use and hospital availability.

If you had a problem with AlloDerm it the past, it is hard to predict if that would happen again or not, regardless of product used.


Ohio Plastic Surgeon
5.0 out of 5 stars 17 reviews

AlloDerm or Strattice - which is better for breast reconstruction?

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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.  Both of these are basically a product of acellular derma matrices - AlloDerm being human cadaveric and Strattice being porcine cadaveric.  There are others.  Which type or product used is surgeon preference.  

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.

Lewis Albert Andres, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 11 reviews

Strattice and alloderm used same way. Surgeons preference and comfort is key

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AlloDerm is essentially cadaver skin minus any living cells.  It is used as a scaffold through which a persons living cells can grow into.  It has many uses, but, in use his in breast reconstruction.  AlloDerm does not help in mastectomy recovery.  It does however help in breast reconstruction. In this application, AlloDerm was used to cover the lower portion of an implant that spans from the lower border of the pectoralis muscle to the breast fold.  Because AlloDerm is a foreign substance in can always get infected and as such your doctor and you need to pay close attention to the signs and symptoms.  AlloDerm has also been used in nipple augmentation as well as augmentation of other body parts.  Its efficacy is really not known in these realms because it is not common.  Some providers may use AlloDerm for these applications but please note that its most widespread use is particularly in breast reconstruction as well as repair for abdominal wall hernias.  Please speak with a board certified plastic surgeon if you have any specific concerns regarding your care.

Raj S. Ambay, MD
Tampa Plastic Surgeon
4.0 out of 5 stars 13 reviews

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Alloderm or Strattrice - Which is Better for Breast Reconstruction?

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The other option to Alloderm or Strattice (Acellular Dermis)  is the use of synthetic mesh

There are three absorbable meshes currently available,with two under FDA studies

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

AlloDerm vs Strattice

+1

AlloDerm, as my colleagues have stated, is an acellular dermis matrix product (ie a sheet of collagen harvest from a human cadaveric course).  This matrix of collagen creates a retaining envelope or hammock for the implant. This helps to create a more natural and aesthetically pleasing breast contour and shape in implant based breast reconstruction.  

Strattice is also a dermal matrix product but from a porcine (pig) source.  

Both are good options.  Most plastic surgeons use AlloDerm for breast reconstruction because of its slight advantage with elasticity.  However, Strattice also has a pliable product that is good for breast reconstruction.  To my knowledge there are no head-to-head studies comparing the two.   

I generally use Strattice pliable for implant based reconstruction (yes, I am in the minority).   In my experience, I have seen a very significant decrease in fluid collections/seromas with strattice as compared to Alloderm.   Please talk to your PS about your concerns.

Again, both are good options.

Dr Basu

 

C. Bob Basu, MD, FACS
Houston Plastic Surgeon
4.5 out of 5 stars 113 reviews

Alloderm or Strattice in breast reconstruction?

+1

Both Alloderm and Strattice are acellular dermal matrix tissue (ADM), the former from human tissue and the later from pigs. They both can help tremendously in breast reconstruction and are used extensively. The Alloderm is more pliable and stretchable versus the Strattice which is more rigid.

There is no extensive double-blind study comparing the two and it is largely surgeon preference for usage. It seems that the Alloderm is incorporated a little bit earlier than the Strattice.

Steven Turkeltaub, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 20 reviews

Both materials can cause drainage

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Alloderm (from human tissue) and Strattice (from pig tissue) are both acellular biologic materials used in breast reconstruction to reinforce coverage for a breast implant or tissue expander.  Both are useful and both can lead to prolonged drainage for which drains are indicated for at least 7-10 days after surgery.  The choice of one or the other depends on several factors including the mechanical properties which differ between the two.

Your surgeon will help to sort out the best option for your needs. 

David J. Levens, MD
Coral Springs Plastic Surgeon
5.0 out of 5 stars 17 reviews

Alloderm vs Strattice for breast reconstruction

+1

Both products are what are called an acellular dermal matrix, which is the full thickness of skin with all of the cells removed. They become incorporated as your own living tissue and work as a sort of living internal bra. Alloderm stretches a little bit more than Strattice and seems to incorporate into your tissue more quickly, which are favorable properties for breast reconstruction especially when a tissue expander is used. Strattice is used more often for revisions of breast augmentation for things such as bottoming out or for coverage of rippling when the tissues are thin. Given your history, it sounds like the Alloderm may not have taken quickly enough and Strattice would not be a better alternative. Other brands of acellular dermal matrices don't really incorporate at all so that isn't the way to go either. It is important to have a suction drain in place to help the graft get started and this is typically in for at least 7 days and often more.

Richard Baxter, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 23 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.