Breast augmentation revision with ADM? (Photo)

Question

I had breast revision w implant and alloderm adm 5/2020. The adm insertion distorted the shape of my right breast . It’s been two years and it’s extremely uncomfortable and unattractive. Is it possible to do a revision and remove the dermal matrix ? I can feel the perm stitches through my skin and have an indentation through the center of my breast / top of the adm . It’s like soft breast tissue on the top of my breast and from the center of my areola down the lower breast the skin is TIGHT now

Joshua T Halka, MD · Answer

Hello,
It is always possible to perform a revision. You could consider changing the pocket, using a mesh for an "internal bra", or encircling the entire implant with ADM. Any surgeon would likely need to know what exactly was done before in your surgeries to come up with a good pre-op plan for a revision.

Anna Steve, MD · Answer

Occasionally dermal matrices like Alloderm can cause contour abnormalities after breast reconstruction and breast revision cases, especially if if does not become incorporated into your own tissue. In these cases the Alloderm that has not been incorporated can be removed to improve contour. In some of these cases I replace alloderm with a different type of internal bra that is totally dissolved and replaced by your own body over time (galaflex). The Galaflex products are made out of the same material as dissolving stitches, so absorbed and replaced by collagen over time. In women with limited soft tissue coverage combining fat grafting can also assist with improving overall contouring and improving the naturalness of the results.

Randal Haworth, MD, FACS · Answer

Removing the dermal matrix (Alloderm ADM) is a possibility, but the feasibility and the specific approach would depend on various factors, including the extent of the distortion, the condition of the surrounding breast tissue, and your overall health.

During your consultation, the surgeon will evaluate the current state of your breasts, including the tightness and the presence of perm stitches. They may recommend revision surgery to address the issues you're experiencing, which could involve removing the dermal matrix, adjusting the implant position, or addressing any other factors contributing to the distortion and discomfort.

I hope this helps,
best of luck !

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