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About 10 years ago I started using alloderm for breast reconstruction cases where an extra layer of support was needed for the implants. I subsequently published an article proving that it becomes living tissue in this application, and it has now become a standard technique. It is made from human skin from a tissue bank, and was originally developed to replace the deep layer of skin for burn victims. It consists of the deeper skin layer with all of the cells removed, so it is essentially a sheet of collagen. The body recognizes it as "self" and sends in your own cells to populate the graft, along with blood vessels,etc.
If you think about the weakness created during a mastectomy and the loss of support, it makes sense to use something like alloderm to reinforce the pocket. Unlike synthetic meshes which can encapsulate or become infected, alloderm, ideally, becomes integrated into you and is revascularized. Good luck.
The use of the acellular dermal matrix (e.g., AlloDerm, FlexHD, AlloMax, etc.) has grown in its applications and use in plastic & reconstructive procedures, and growing. It has truly been a remarkable addition for breast reconstruction.The acellular dermal matrix is a tissue that is specially-prepared, which comes from cadaveric skin. It is placed on the inside, not on your skin. It has been processed in such a way that the basement membrane and cellular matrix remain intact, while removing all other cellular components that may lead to both rejection and infection. Packages as a sterile tissue product, due to its preparation, the chance of acquiring viruses and such is nearly absent.Its applications for breast reconstruction alone include its use in tissue expander/implant reconstruction, to act as a "hammock" at the inferior portion of the breast for which the implant lies within. This creates a natural "sling" which mimics the ptosis (sag) of the breast, while supporting it in place. By suturing this matrix to its exact position of the breast margins, the plastic surgeon is able to precisely recreate an excellent contour for your breast, especially at the inferior, medial, and lateral positions. This also minimizes migration of the implant, as sometimes seen with "bottoming out" inferiorly or its displacement into the axilla (armpit). In addition to its increased aesthetic results, the acellular dermal matrix provides additional coverage over your implant. This is especially useful in those instances of dehiscence (your incision opening up), thus protecting the implant from exposure, and threatening its necessity for removal. Furthermore, in cases where the overlying mastectomy flaps are thin or damaged, leading to partial flap necrosis, the tissue matrix again provides a coverage over your implant, which can heal over time or a graft placed over the are or simply closed. Lastly, the additional coverage lessens implant visibility and palpability and is a great adjunct for revisionary breast surgery. The use of this matrix, along with the advantages listed above, has reduced the time of the reconstructive portion of the procedure as well. There is less pectoralis muscle retraction and eliminates the need to raise any other surrounding muscles in order to achieve complete implant coverage.
Alloderm is acellular dermis. There is also a new competing product introduced called FlexHD and BellaDerm that I plan to trial in the near future. As the other plastic surgeons had mentioned it has been widely used in abdominal surgery and breast reconstruction. Facial plastic surgeons use this product occasionally to smooth nasal contour or build up the nasal bridge in revision rhinoplasty. Also in reconstruction, acellular dermis can be used to cover implant materials or to provide bulk to the reconstructed area. It is a safe product to use but is not living tissue. Therefore it should be used cautiously and only by surgeons experienced in its use.Stephen Weber MD, FACS
AlloDerm is a brand name. This is an cellular dermal matrix where the host cells could grow through and incorporate the product in the host's body. This product has become very popular because it provides a great advantage in prosthetic breast reconstruction. One can create a sling under the prosthesis and produce a much more natural breast shape.I use it few time every week. This product is marketed under several other name even though they are different in the way they are processed, most produce similar results.
Alloderm is a tissue matrix that is used during breastreconstruction. After a pocket has beencreated for the expander or implant following a mastectomy, Alloderm is placedinside the pocket and stitched into the chest wall to keep it in place. Onceit is secured the Alloderm acts as reinforcement for patients who have lessthan ideal skin which is extremely helpful for patients who have undergoneradiation. Another benefit of Allodermis that it also helps the body stabilize the implant and reduces implantmigration. I recommend continuing yourresearch on RealSelf as it is a highly valuable tool for anyone consideringsurgery. If you decide to undergosurgery make sure your surgeon is a board certified plastic surgeon.Be well and good luck!@norrisplastic
AlloDerm is essentially cadaver skin minus any living cells. It is used as a scaffold through which a persons living cells can grow into. It has many uses, but, in use his in breast reconstruction. AlloDerm does not help in mastectomy recovery. It does however help in breast reconstruction. In this application, AlloDerm was used to cover the lower portion of an implant that spans from the lower border of the pectoralis muscle to the breast fold. Because AlloDerm is a foreign substance in can always get infected and as such your doctor and you need to pay close attention to the signs and symptoms. AlloDerm has also been used in nipple augmentation as well as augmentation of other body parts. Its efficacy is really not known in these realms because it is not common. Some providers may use AlloDerm for these applications but please note that its most widespread use is particularly in breast reconstruction as well as repair for abdominal wall hernias. Please speak with a board certified plastic surgeon if you have any specific concerns regarding your care.
Alloderm is an acellular dermal matrix that is used for breast reconstruction. Our bodies use the allograft as a scaffold in which to incorporate (grow into) new tissue. It is sewn from the muscle to the chest wall in order to stabilize the tissue expander. The tissue expander is placed under the muscle and alloderm. Your breast skin will then grow into the alloderm forming an extra protective layer between the implant and the outside world. You often need fewer offices visits to place saline in the expanders and typically have a shorter reconstructive couse. Alloderm has been very well studied in breast cancer reconstruction and is known to have a higher infection rate(~15% higher) and seroma rate (~10% higher) than traditional breast recon. (Seroma = collection of fluid) However the infection and seroma rates can be effectively lowered by good patient selection (non smoker, no diabetes, no obesity), and good surgical technique (good hydration of the allograft prior to placement, strict hemostasis, proper drain placement and time (typically 5-7 days), securing the allograft to the underside of the skin, and proper orientation of the allograft (there's an up and a down side)). Even with the higher reported rate of inection and seroma I have not seen this to be a problem. Alloderm has a long history of being safe in the body. It is my choice of allograft for reconstruction as the integration rate is superior to all other allografts. Meaning it becomes part of you very quickly. The other types of allografts use various chemical treatments which delay integration and may lead to infection and non integration. I hope this helps.
Thanks for the question. Acellular dermal matrix (ADM) is a biological implant that carries the ability to become integrated into native tissue. It is made by taking a full thickness section of skin from a donor source (human cadaver, porcine, or bovine in origin). In the case of human donors, the tissue is screened for infectious diseases such as HIV and hepatitis. Cellular elements are removed from the tissue. ADM can be helpful in improving contour for significant irregularities after breast surgery. For example, top ability/rippling a breast implants maybe covered or camouflaged with the use ofADM. in addition significant income opposition can be corrected with ADM providing additional support for the implant. This can be especially helpful for patients with a paucity of skin elasticity or soft tissue coverage. For example, ADM has been use successfully to reinforce and support capsulorraphy to treat symmastia (medial malposition of breast implants), bottoming out (inferior malposition of breast implants), or lateral displacement (implants falling sideways especially when patient lies down) of breast implants. I hope this helps.
AlloDerm, as my colleagues have stated, is an acellular dermis matrix product (ie a sheet of collagen harvest from a human cadaveric course). This matrix of collagen creates a retaining envelope or hammock for the implant. This helps to create a more natural and aesthetically pleasing breast contour and shape.
