my research of Mastectomy shows that some surgeons used Alloderm. Wondering what it is and how it helps the Mastectomy recovery
What is Alloderm?
Doctor Answers (19)
What is Alloderm?
Alloderm is a collagen matrix that is acellular in nature. That is to say, it is cadaver skin that has had all the cells taken out of it, and just leaves the collagen behind. It is like having a shell of a building there, without all the walls, furniture, and people living inside. This makes it easy for your own body to incorporate your own blood vessels and tissue into the Alloderm.
This is being used most currently for hernia operations to cover the hernia, but also in breast reconstruction. I have used it recently to be able to place an implant in the reconstruction patient at the same time that they have the mastectomy. The Alloderm is placed between the Pectoralis muscle and the inframammary crease to essentially lenghthen the muscle to cover the implant. For me and my patients, this has been a wonderful adjunct, as there is the possibility that we may be able to eliminate one step (or surgery) in completing their reconstruction.
Alloderm can also be very helpful in the patient that has ripples with their implant, as it can add a layer of tissue where the tissue is too thin. So it can be used in breast implant cases, at times, when appropriate.
As always, you should ask your Board Certified Plastic Surgeon about Alloderm. He knows what options would be best in your specific case when he does a physical exam on you and asks about your history. A surgeon who is a member of the American Society for Aesthetic Plastic Surgery (ASAPS) does most of his work in aesthetic surgery.
Alloderm is used in breast reconstruction
Alloderm is a regenerative tissue matrix that is used to improve the breast pocket in breast reconstruction with implants or expanders, It is made from huma skin that is washed free of cells, including human cells, bacteria, and viruses. Your body cannot be infected by or reject Alloderm. It is actually incorporated into natural tissues, unlike other tissue matrices on the market. Alloderm is used to cover the implant or expander, and to control the shape and size of the new breast.
Alloderm is a regenerative tissue matirx for breast reconstruction
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.
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Common uses for AlloDerm.
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.
Alloderm and its use in breast reconstruction.
Alloderm is an acellular dermal matrix that is used for breast reconstruction. Our bodies use the allograft as a scaffold in which to incorporate (grow into) new tissue. It is sewn from the muscle to the chest wall in order to stabilize the tissue expander. The tissue expander is placed under the muscle and alloderm. Your breast skin will then grow into the alloderm forming an extra protective layer between the implant and the outside world. You often need fewer offices visits to place saline in the expanders and typically have a shorter reconstructive couse.
Alloderm has been very well studied in breast cancer reconstruction and is known to have a higher infection rate(~15% higher) and seroma rate (~10% higher) than traditional breast recon. (Seroma = collection of fluid) However the infection and seroma rates can be effectively lowered by good patient selection (non smoker, no diabetes, no obesity), and good surgical technique (good hydration of the allograft prior to placement, strict hemostasis, proper drain placement and time (typically 5-7 days), securing the allograft to the underside of the skin, and proper orientation of the allograft (there's an up and a down side)).
Even with the higher reported rate of inection and seroma I have not seen this to be a problem. Alloderm has a long history of being safe in the body. It is my choice of allograft for reconstruction as the integration rate is superior to all other allografts. Meaning it becomes part of you very quickly. The other types of allografts use various chemical treatments which delay integration and may lead to infection and non integration.
I hope this helps.
Thanks for the question.
Acellular dermal matrix (ADM) is a biological implant that carries the ability to become integrated into native tissue. It is made by taking a full thickness section of skin from a donor source (human cadaver, porcine, or bovine in origin). In the case of human donors, the tissue is screened for infectious diseases such as HIV and hepatitis. Cellular elements are removed from the tissue.
ADM can be helpful in improving contour for significant irregularities after breast surgery. For example, top ability/rippling a breast implants maybe covered or camouflaged with the use ofADM. in addition significant income opposition can be corrected with ADM providing additional support for the implant. This can be especially helpful for patients with a paucity of skin elasticity or soft tissue coverage. For example, ADM has been use successfully to reinforce and support capsulorraphy to treat symmastia (medial malposition of breast implants), bottoming out (inferior malposition of breast implants), or lateral displacement (implants falling sideways especially when patient lies down) of breast implants.
I hope this helps.
AlloDerm in breast reconstruction
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.
Alloderm for eyelid reconstruction
Alloderm is an acellular dermal matrix - derived from cadaveric skin which i stripped of the antigenic epidermis and then treated with chemical, irradiated and freeze dried. It is useful in eyelid reconstruction, particularly in patients with eyelid retraction or scarring.
Alloderm is a protein lattice for your own tissue ingrowth
Alloderm is used for many reasons, in my practice I most commonly use it for tissue augmentation such as lip augmentation, revision rhinoplasties, or if tissue support is needed in secondary cosmetic breast cases. I have found long term maintenance of volume to be approximately 60-70%, and patients have been very happy with results.