Breast Revision Using ADM (Acellular Dermal Matrix)? (photo)

Acellular dermal matrix  has become popular as a way of dealing with implant encapsulation. I have no experience with it, but I have heard it is quite successful in preventing recurrent encapsulation.  There are some other considerations, however.  A lift with  new silicone implants and ADM is going to be  a pricey  undertaking.  Plastic surgeons seem to be a little overly anxious to jump on the ADM bandwagon, not knowing  what the long term implications are.  I would probably opt for a simple  capsuletomy and implant replacement.  A lift would be optional but not absolutely necessary.

Hello,

I believe you've posted before, no? I disaggree with both doctors.  High profile implants will give you a ballish look like a contracted implant, especially if your tissues are thin.  In addition, they cause more long term thinning of your tissues, and are more likely to drop down out of the cover of your muscle, kind of where your implants are now.  It is in vogue to use these implants because the companies push them, and surgeons are not aware of their long term effect.

ADMs are great devices and they have enabled reconstructive surgeons to perform one stage breast reconstruction with incredible beauty and a natural appearance.  There has been a transfer over to the cosmetic usage of ADMS with reinforcing breast implant capsules for support and to minimize rippling.  There is most recently talk of using them for recalcitrant capsular contracture.  My feelings are that they are unnecessary and overly expensive (more than a pair of silicone gel implants).  Adhering to the principles of placing a new, properly sized, moderate profile implant in the submuscular position after a true total capsulectomy will likely halt recurrent capsular contracture most of the time.  The addition of a leukotriene inhibitor like Singulair or Accolate might be considered.  However, Accolate exposes you to a small but real risk of liver toxicity, so I only use Singulair.

Looking at your photo shows that your implants are in a low position and have dropped into the sagging portion of your breast.  Removal of your implants with the entire capsule, replacement with new, moderate profiled implants with a 'no touch' technique, followed by a formal mastopexy will produce a result that will look pretty and will likely not recontract.

Best of luck!