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About 10 years ago I started using alloderm for breast reconstruction cases where an extra layer of support was needed for the implants. I subsequently published an article proving that it becomes living tissue in this application, and it has now become a standard technique. It is made from human skin from a tissue bank, and was originally developed to replace the deep layer of skin for burn victims. It consists of the deeper skin layer with all of the cells removed, so it is essentially a sheet of collagen. The body recognizes it as "self" and sends in your own cells to populate the graft, along with blood vessels,etc.
If you think about the weakness created during a mastectomy and the loss of support, it makes sense to use something like alloderm to reinforce the pocket. Unlike synthetic meshes which can encapsulate or become infected, alloderm, ideally, becomes integrated into you and is revascularized. Good luck.
The use of the acellular dermal matrix (e.g., AlloDerm, FlexHD, AlloMax, etc.) has grown in its applications and use in plastic & reconstructive procedures, and growing. It has truly been a remarkable addition for breast reconstruction.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.
Alloderm is acellular dermis. There is also a new competing product introduced called FlexHD and BellaDerm that I plan to trial in the near future. As the other plastic surgeons had mentioned it has been widely used in abdominal surgery and breast reconstruction. Facial plastic surgeons use this product occasionally to smooth nasal contour or build up the nasal bridge in revision rhinoplasty. Also in reconstruction, acellular dermis can be used to cover implant materials or to provide bulk to the reconstructed area. It is a safe product to use but is not living tissue. Therefore it should be used cautiously and only by surgeons experienced in its use.Stephen Weber MD, FACS
AlloDerm is a brand name. This is an cellular dermal matrix where the host cells could grow through and incorporate the product in the host's body. This product has become very popular because it provides a great advantage in prosthetic breast reconstruction. One can create a sling under the prosthesis and produce a much more natural breast shape.I use it few time every week. This product is marketed under several other name even though they are different in the way they are processed, most produce similar results.
