Acellular dermal matrix in regards to capsular contracture

#Capsular #Contracture is a condition in which the capsule around the implant thickens and squeezes the implant making it hard and often changing the shape and position of the implant. It is more common in nicotine users (e.g. smoking or nicotine patches or gum). Effective treatment of the capsule frequently involves completely removal of the capsule (capsulectomy), and occasional incisions in the capsule may be somewhat helpful (#capsulotomy). In the past, closed capsulotomy, in which the breast is squeezed until the #capsule breaks, was used. Currently, most doctors avoid this technique because of complications associated with the technique and because the implant companies will void their warranty if this technique is used. At times it is necessary to change the position of the implant, either above or below the muscle, depending upon the initial position, changing the #implants themselves and, on occasion, the use of Acellular Dermal Matrix (#ADM) may be required to prevent continued problems. A biologic fabric such as an ADM (Acellular Dermal Matrix) can be used to internally attach to the breast tissue while #supporting the implant.

I appreciate your question.
Capsular Contracture is sadly a common occurrence with breast augmentation. I use an IMF incision and antibiotic irrigation to keep the incidence low.  When I'm concerned about capsular contracture I tend to start medical therapy such as singular while working with a primary doctor. If it doesn't get any better in 3-6 months, I then consider removal and replacement of the implants below the muscle while removing the capsule. If they are already under the muscle, I will then consider using ADM. Acellular dermal matrix is a cadaveric graft in which the top portion of the skin (the epidermis or color portion) is removed and the dermis or collagen portion is left behind. All the cells have been removed so it is essentially a collagen graft. Since it is a skin graft, your body grows into it and it becomes your own. This decreases the inflammatory response of healing and so capsulate contracture is less likely.  I have personally seen less recurrence when it is used. I also consider using textured implants as well. Another option if the capsular contracture is long-standing or it recurs, is to remove the implants and perform fat grafting. 
The best way to assess and give true advice would be an in-person exam. Please see a board-certified plastic surgeon that specializes in aesthetic and restorative breast surgery.
best of luck!
Dr Schwartz
Board Certified Plastic Surgeon 
#RealSelf100Surgeon
#RealSelfCORESurgeon

Acellular Dermal Matrix or ADM is derived from skin that has had all cellular material removed so it is only the connective tissue component. The most common ones are Alloderm, used mostly for breast reconstruction, and Strattice, used more for revisions such as capsular contracture. Although it is possible that CC can recur after placement of Strattice, it is the most effective option we have when combined with capsulectomy and implant replacement. Because of the cost, it is most often reserved for cases where CC has recurred after one revision. However, capsulectomy sometimes leaves a thin tissue envelope around the implant, so Strattice may be considered in primare cases to add support and coverage in addition to protection against CC.