How long does AlloDerm last and is there a product that will smooth out the ripples in my breast after reconstruction?

Rippling is more frequently related to the implant style in addition to thin tissues. Alloderm or Strattice are highly effective in reducing the appearance but a high profile implant will likely be important as well. Fat grafting is a very helpful adjunct and it will not require large amounts to be helpful. Lastly if you are wearing a bra that squeezes your implants together OR are sleeping in a way that causes your implants to be pushed toward the center over time this can lead to further thinning of the tissues in the cleavage area. Sleep on your back to avoid this. 

Rippling of the breast after reconstruction is fairly common since a mastectomy removes all but the thinnest layer of fat beneath the surface of the skin. When there is less tissue between the implant and the skin, the natural rippling of the implants is often seen.Options to try and improve this are as follows:1) Use of a highly cohesive implant does not prevent rippling, but they seem to ripple less because of the nature of the gel that is inside the devices.2) Subcutaneous fat grafting and placement of alloderm in the areas of rippling serve to place more natural tissue between the implants and the skin thus disguising the rippling.

Alloderm is commonly used to minimize rippling and improve support of breast implants after expander to implant reconstruction, often at the time of the expander placement. There are other options such as SERI but Alloderm has the longest clinical history. See the link below for a 12-year follow up in a reconstruction case where the Alloderm was completely intact and integrated.

Rippling after expander based breast reconstruction is fairly common and is caused by a combination of things but primarily a fairly thin mastectomy flap and perhaps an overly large pocket. Pockets can stretch with time so this may not become apparent for several years.Treatment is multifactorial but can involve fat grafting, tightening the pocket and /or adding acellular dermal matrix and implant change. Generally your own tissues take over the allograft with time and hopefully the thickening of tissues that it provides will last a long time but I do believe some of the thickness does go away and perhaps forever. I am not sure if long term studies are available on this specific question. Alternate products such as absorbable silk ( Seri) are being used to treated this condition. Studies suggests that tissues thicken with time. Hope this helps.

Unfortunately, the options are somewhat limited.  Placement of acellular dermal matrix such as Alloderm or Strattice may help camouflage the rippling.  The Alloderm becomes incorporated, meaning it becomes a part of your tissues, rather than absorbing.  Another option would be fat grafting to thicken the tissues so the rippling isn't as visible.  However, there would be risk to the implant with this.  Finally, a textured shaped implant may help, but depending on how thin your tissues are, you may still see or feel some rippling.