Considering 2 step tissue-expander surgery with full muscle coverage, an anotomical cohesive gel implant and no Alloderm versus partial muscle coverage with Alloderm and a round cohesive gel implant. I want the most natural results with minimal impact on my upper body strength.
Are There Any Significant Advantages to Using Alloderm in Delayed Bilateral Breast Reconstruction?
Doctor Answers 4
Are there any significant advantages to using acellular dermal matrix in delayed breast reconstruction?
Alloderm for delayed breast reconstruction with tissue expanders
In my practice, I prefer to use an acellular dermal matrix product (such as Alloderm or FlexHD) in conjunction with tissue expanders for breast reconstruction. This allows the expander to sit in a more anatomical location while partially releasing the pectoralis muscle. Expansion can be completed faster and the overall result I have been pleased with. Some patients are better suited for total muscle coverage, but this depends on their overall health, etc...Talk to your surgeon about both options and they will explain what they are most comfortable with.
Advantages of Alloderm in breast reconstruction
Before the use of Alloderm became commonplace, total muscle coverage was the norm. There are several reasons why Alloderm has changed how we do reconstruction now: 1. Expansion of the muscles that Alloderm replaces can be painful and slow; 2. It is very difficult to get a nice round contour over the lower part of the breast with total muscle coverage regardless of the shape of the implant; 3. The time interval for expansion is usually less; and 4. there seems to be a lower chance of capsular contracture around the implant with Alloderm.
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Breast reconstruction and alloderm
I prefer to release the muscle so that the expander or implant is positioned properly in the pocket and also has coverage of the lower pole jsut in case the skin breaks down. This is why I use the alloderm in all these types of procedures.