What is the success rate of using Alloderm to correct Symmastia?
Alloderm for Symmastia?
Doctor Answers 16
Alloderm can be used to recreate folds
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.
Breast augmentation, symmastia, implant complications
Typically I make a new pocket for the device. If there is thinning of the tissue or other factors such as threatened exposure or extrusion of the device then a material like alloderm can be used.
The treatment of synmastia, which fortunately is a rare clinical problem, should
include the use of acellular dermal matrix to reinforce the repair. Essentially, in synmastia, the two implants have combined to create a single plane which extends across the midline, which can give the appearance of one continuous breast. One method to correct this difficult problem is to remove the implants, allow the tissue to heal, and then go back and replace the implants at a slightly different level. If the patient is determined to keep the implants, the repair has to be accomplished and strong enough to wiithstand the same forces that created the problem in the first place. Sutures alone usually will not work, and allograft to reinforce the repair has been extremely helpful.
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Symmastia and Alloderm
Symmastia is a diffficult condition to correct
The availability of acellular dermal matrices such as Alloderm has greatly improved the success rate in treating symmastia,hovever the surgeon should be highly experienced in using these materials
There are several several acellular dermal matrices like Alloderm available .They are obtained fron either human or animal sources .Synthetic meshes can also be used in selected cases
Alloderm has made the treatment of symmastia more predictable and permanent
From reading all the responses, clearly it can be seen that treatment of symmastia is a very difficult problem. It involves multiple variables in order to predictably correct the problem with an aesthetically pleasing outcome. That being said, when performed skillfully, Alloderm is an essential component (and innovation) in the predictable and successful treatment of symmastia.
The biggest issue that I have had with it is the exorbitant cost which most patients have difficulty with - running into thousands of extra dollars. It does provide a great solution but at a great cost, so to speak (financially)!
Repair of Symmastia (Uniboob)
Symmastia, also known as uniboob, is a challenging problem to correct. To correct this problem, usually multiple techniques are used, including changing pockets (neopectoral) for the implant, changing the size of the implant (e.g., narrower implants), reinforcing the repair with sutures and AlloDerm or another similar type of material (e.g., Strattice). With this combination of techniques, the rate of success in repairing symmastia is close to 100%, per peer-reviewed journal articles.
High success with Alloderm or Strattice for symmastia correction
Symmastia occurs when breast implants are placed too close together and the tissue (skin) in between lifts up. One thing that causes it is implants that are too large in diameter, so the first principle of correcting it is to replace the implants with ones that have appropriate dimensions if necessary. However, what happens in symmastia whether or not the implants are too wide is the muscle attachment to the breastbone comes undone, so there is no longer a barrier to the implants moving inward. Re-attaching the muscle has a very low success rate but reinforcing the repair with Alloderm or Strattice is very reliable.
Symmastia repair with Alloderm
Symmastia (medial malposition breast implants) can be corrected with high likelihood of success (about 90% success rate) is using medial breasts implant pocket sutures (medial capsulorrhaphy), lateral capsulotomy (if necessary), and/or the use of allograft. I do not believe that a staged procedure, involving removal of implants for period of time, is necessary.
There is a learning curve with this operation and I recommend that you seek consultation with a board-certified plastic surgeon with significant experience treating this problem. You may find the link attached below helpful.
Synmastia repair is one of the hardest things to reliably correct and get a stable, long term result. Luckily it is rare, but for those of us who specialize in revision breast surgeries, it is the most challenging. The use of Alloderm or Strattice has become common place, and really helps to reinforce the medial areas and helps define where the implants are going to sit. It is not always necessary, but can be a very powerful adjunct to repairing the pocket/ muscle/ etc.
AlloDerm will reinforce the repair of the symmastia. Because suture alone may not hold because of the thin skin and pressure of the implants pushing up on the skin.
Other methods is to change the position of the implant.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.