What happens if the Alloderm isn't incorporated on the lower breast skin flap? If it is free floating in the breast pocket?

Though rare, non-incorporation happens. The alloderm does not develop cellular integration and new blood vessels within the tissue to which it was transferred. In this case, the graft can be sterile and in the same capsule as the breast implant or tissue expander. Sometimes this can be a problem, but most of the time doctors and patients are unaware.In most cases, there is only a portion of the alloderm that is not incorporated and when I encounter this in breast reconstruction patients, for example when the expanders are changed for implants, I will remove the portion that is not integrated.

Yes the part that is not attached can be free-floating. However it is pretty rare to have the entire piece not incorporate. Therefore, even with only a few spots incorporate they will hold the entire piece of Alloderm in place. If it was free floating you would be able to feel that as a mobile lump and I doubt that will ever happen.Good luck!