Allograft (Alloderm), Breast Enhancement, Internal Sutures (Internal Bra), Revision Breast Surgery, Silicone gel Implants

This 45 year old mother wanted to have breast revision surgery performed by Dr. Pousti. She was status 9 years post breast augmentation surgery performed by another surgeon and desired to achieve more roundness and cleavage in her breasts. She was experiencing inferior displacement of bilateral breasts which was causing pain and Dr. Pousti determined she would be an excellent candidate for breast revision surgery. The markings were performed on the morning of surgery and the patient spoke with Dr. Pousti regarding any last questions. Dr. Pousti determined that the use of ADM would be necessary in the breast repair. ADM also known as AlloDerm is made from donated human skin. It is handled in much the same way as other transplantable organs. The tissue is processed to remove cells that might cause your body to reject the foreign tissue or react negatively to it. What’s left is the collagen structure (fiber-like proteins) and other proteins naturally found in skin. This structure acts as a frame for your tissue to grow into and around. There are multiple purposes for AlloDerm but for this patient, the AlloDerm was used to prevent rippling and add an additional layer of support between the skin and the implant. Because of the patient athletic build, the addition support would reduce the risk of further implant rippling or palpability. Dr. Pousti also determined that a 2 layer repair of the inframammary fold would be beneficial. Bilateral capsulorrhaphy is performed to close off the breast pocket and prevent displacement. A sizer is used to help Dr. Pousti determine which implant will be the best to help the patient achieve her goals. She is currently only 2 weeks post surgery and has bilateral 545cc high profile Sientra silicone gel breast implants. The bolster dressing will remain in place for 2 more weeks and provides support to the internal bra repair performed by Dr. Pousti.