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Revisional Breast Reconstruction for Capsular Contracture - Best Option?

asked 1 year ago by Selden in Selden, NY
Latest answer by Fredrick A. Valauri, MD
Question viewed 390 times
Tags: best, capsular contracture, options, revision

I went to 4 surgeons and got 4 varied recommendations. I am unable to decide the way to go....2 out of 4 would use alloderm. I am concerned about the risk for infection using that matrix-I don't want the long surgical procedure of diep or tram. I am therefore just unable to go ahead since there are obvious pros and cons using alloderm.

8 answers to Revisional Breast Reconstruction for Capsular Contracture - Best Option?

+3

Options for capsular contracture in breast reconstruction

If you are experiencing capsular contracture following implant reconstruction, you have several options.   One option is to consider an autologous reconstructive option such as a TRAM or DIEP free flap.  If you have enough excess tissue in your lower belly, then you may be able to restore your post mastectomy breast using your own tissue without an implant.   Another option would be the latissimus flap with an implant.  If you are not interested in an autologous... more
C. Bob Basu, MD

Houston Plastic Surgeon

www.basuplasticsurgery.com

+1

Treatments of Recurrent Breast Implant Capsular Contractures

Treatments for breast implant capsular contractures include the with or without AlloDerm, removal and replacement of the breast implant along with capsulectomy to remove the scar capsule; exchange of the breast implant and placement of a new implant in another pocket; removal of the implant and breast reconstruction with a tissue flap Flap reconstruction of the breast makes it possible, using your own tissues, to provide a soft, natural, warm breast reconstruction. Although more... more
Fredrick A. Valauri, MD

New York Plastic Surgeon

www.drvalauri.com

+1

Revision breast reconstruction with Alloderm works.

Hi. 1)  Most of the time, capsular contracture can be corrected just with your existing tissues, without the need for either Alloderm or a flap. 2)  If Alloderm is indicated for some other reason (rippling, thin tissues, etc.), I assure you that we use it all the time, that it  is very safe, and that the risk of infection is very low.  There are really no "cons" here.  And Alloderm actually lowers the risk of capsular contracture coming back... more
George J. Beraka, MD

Manhattan Plastic Surgeon
+1

Alloderm is excellent choice for treatment of capsular contracture

Sometimes it can be confusing given the fact that often there is no one great answer and therefore no consensus. It doesn't mean that there is a "wrong" answer. Given that you don't want the far more extensive procedures which is a quite reasonable decision, using Alloderm is an excellent choice and is what I like to use. The Alloderm significantly reduces the incidence and extent of capsular contracture even in irradiated tissue though the effects are even better... more
Steven Turkeltaub, MD

Scottsdale Plastic Surgeon
+1

Capsular contracture and implants

Of course, without a physical exam by me, I am not sure what is going on for you.  However, Alloderm is being used quite often for capsular contracture  because it seems to diminish the recurrence.
Steven Wallach, MD

Manhattan Plastic Surgeon
+1

Strattice acellular matrix for capsular contracture

The best chance of correcting capsular contracture is probably with implant replacement, removal of the capsule, and acellular dermis graft. Alloderm is popular for this application because it was found to be associated with an extremely low incidence of CC in breast reconstruction patients. There is some theoretical concern however, because technically alloderm is aseptic, not sterile. A good alternative is a similar material called Strattice, which is sterile and works the same way as... more
Richard Baxter, MD

Seattle Plastic Surgeon
+1

Options for Capsular Contracture after Breast Reconstruction

According to information published by one of the major manufacturers of breast implants: “Breast implants are not considered lifetime devices. You will likely undergo implant removal with or without replacement over the course of your life.” Data published by the by the U.S. Food and Drug Administration show that: Approximately 50% of women will require unplanned re-operation within 7 years of undergoing reconstruction using saline-filled implants Implant... more
David Greenspun, MD, MSc

New York Plastic Surgeon

www.davidgreenspunmd.com

+1

Acellular dermal matrix is a good option for capsular contracture

Acellular dermal matrix (ADM), of which Alloderm is one option, seems to be beneficial for people with capsular contracture.  It may work where previous capsulotomy or capsulectomy has failed to prevent the contracture from recurring.  Other manuevers should be used as well - implant exchange, creating a new pocket for the implant, etc.  I wouldn't be too worried about infection - although the risk might be slightly higher, it is still very low.  There is a higher... more
Douglas J. Mackenzie, MD

Santa Barbara Plastic Surgeon

www.pacificplasticsurgery.com

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