Is Contracture After Strattice Common?
Doctor Answers (11)
Alloderm and Strattice
Dear Orlando, there are no guarantees with alloderm or strattice however I have used them in many cases including redo breast surgery, severe bottoming out,recurrent capsules, severe wrinkling, complex breast reconstructions after mastectomy and even on cases of symammia. In using well over 100 sheets of alloderm I am convinced that this does improve capsular contracture in most patients. I find I use it more and more as I see the long term results. I have seen no rejection, but I also prefer alloderm over strattice. Good luck, Dr. Schuster in Boca Raton.
Strattice appears to reduce chances of capsular contracture
Strattice is a form of what are called Acellular Dermal Matices, or ADM's. These are materials that support the growth of the patient's own tissue and for that reason they bacame popular with breast recontruction to support implants. With time it became clear that the incidence of capsular contracture in these patients was very small compared to what was expected. I have used it now on several cases of augmentation patients who had capsular contractures and it has been successful in each case.
Strattice and repeat capsular contracture
Repeated episodes of capsular contracture are very frustrating, for both surgeon and patient. Currently, the only way to 100% guarantee that you won't ever have any more capsules is to remove the implants, and not replace them. This is a challenging decision for many women to make. With new fat grafting techniques, however, there is a potential alternative to implants out there now.
Alternatively, some surgeons, including myself, will try capsulectomy with placement of Strattice. Early experience with Strattice in breast reconstruction suggests that it lowers the rate of capsular contracture around an implant. Lowers, not "eliminates". So far, I haven't seen any published literature on this for cosmetic patients, but one can guess that the experience should probably be similar.
Yes, it is indeed very expensive to use the Strattice for self-pay patients. But, it's really the last option to try, before giving up and taking the implants out.
Hope that helps. Come and see me in Altamonte Springs if you would like to discuss this in more detail.
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Breast Augmentation, Breast Enlargement, Breast Implants
For some patients the use of Strattice or Alloderm has been the only solution for their complex recurrent breast augmentation problems. Seek out a plastic surgeon that has experience using these products. Yes they are expensive but so is having repeated surgery.
Breast implant revision with Strattice
Allografts such as Strattice, which is collagen from the dermis of pig skin, has been useful in improving coverage of breast implants in reconstruction after mastectomy. Experience has shown that the capsular contracture rate is lower, and Strattice has been used for some with severe capsular contacture after breast augmentation. The jury is still out as there is incomplete data to know the success. As others have mentioned there is no guarantee. Concerning risk, there is a higher rate of fluid collections and infection, and wound separation with allografts. You and your surgeon must come to an understanding of the risk vs. reward.
Best of luck,
Recurrent Capsular Contracture Is a Bacterial Problem
Dear Orlando 228,
I am sorry that you have had recurrent capsular contracture. Acellular dermal matrices like Alloderm and Strattice are not a replacement for the techniques best known to treat recurrent capsular contracture. These products are designed to provide tissue support and 'padding'.
Recurrent capsular contracture occurs because either patients have a high propensity for scar formation and/or there was a failure of the surgical techniques utilized, possibly because those techniques were insufficient or not the best techniques available. There are a few important things to be done surgically that will minimize recurrence of capsular contracture. It is important to completely remove all of the scar capsule and the implant contained within it, which is known as 'en bloc total capsulectomy'. If the implant was in the subglandular position, a new subpectoral pocket should be created for implant placement, if possible. If the implant was already in the subpectoral position, a drain should be placed to help remove fluids from building up around the implant during the first week of healing. Finally, a new implant should always be used to minimize cross contamination of the new pocket.
Acellular dermal matrices are frequently used if your tissue is thin or lost elasticity, and may be helpful in women who have had multiple capsular contractures and multiple capsulectomies.
I wish you the best of luck!
Capsule contracture can occur and reoccur after surgery in the breast area. Strattice is a newer solution to this problem and early results appear very favorable. I have not heard of any rejection problems.
All the best,
Tal Raine MD FACS
Is Contracture After Strattice Common?
To answer your question - NO! But it could occur. Best to consult with Dr. Jason Pozner in Boca, he is the lead investigator for these acellular dermal matric products. Best of luck from MIAMI
Strattice for implant capsular contracture
It is true strattice is expensive and that there are no guarantees that it will resolve your capsular contracture, but it is a reasonable option in the setting of recurrent contracture. I personally have not had any "rejection" issues with strattice.
Strattice is expensive
Plenty of surgeons that have a lot of experience with acellular dermal matric products like Strattice, Alloderm etc tout the ability of these materials to act as a 'firebreak' for implant CC. I don't have enough experience with the product to make a definitive statement about it. I do have two patients that I plan to use Strattice with for recurrent CC.