35-44 year old woman treated with AlloDerm

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This 35 year old patient desired breast revision surgery and an abdominoplasty to achieve better proportions and feel more comfortable in her skin. She was post previous breast augmentation and presented with implant encapsulation, breast asymmetry, and a desire to improve breast size, shape, symmetry, and feel. Dr. Pousti recommended a stage 1 (Benelli) breast lift in order to raise the position of the areola and achieve a better outcome. After 3 pregnancies, the patient presented with excess skin and adipose tissue of abdominal wall associated with abdominal wall laxity. The patient was experiencing capsular contracture which is excessive scar tissue buildup around the breast implant post surgery. The cause of capsular contracture is unknown, but it is the most common complication with breast augmentation surgery. There are different grades of capsular contracture ranging from mild to severe. The rate of capsular contracture has decreased from 20-30 years ago when all breast implants were placed above the muscle (sub-glandular). By placing the breast implants below the muscle (sub-muscular), the rate of capsular contracture has significantly decreased. Also, it is said that massaging of the implants helps decrease the chance of capsular contracture. When a patient is believed to be developing capsular contracture or hardening of the breasts, they may be placed on a medication called Accolate. This is an asthma medication that has shown to improve capsular contracture in patients at an early stage. When a patient develops severe capsular contracture, the treatment would be to return to the operating room and perform a capsulectomy on the patient. AlloDerm, also known as ADM or is an acellular dermal matrix, derived from donated human skin tissue. Since AlloDerm is regarded as minimally processed and not significantly changed in structure from the natural material, the FDA has classified it as banked human tissue. It has been shown to reduce and even prevent the chance of capsular contracture from occurring. The Allograft is placed between the breast implant and the patients skin to add another layer of support. The patient is currently 4 months post mommy makeover and has bilateral 750cc Natrelle Silicone Gel Breast Implants.

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