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There are many challenges faced by plastic surgeons as they strive to achieve optimal results in implant-based breast reconstruction. These include providing sufficient implant soft tissue coverage and support, defining a natural breast shape and avoiding problems like capsular contracture or uncomfortable tightening of the breast implant. With the use of an acellular dermal matrix such as AlloDerm®, these challenges can be addressed in both expander implant reconstruction as well as direct-to-implant reconstruction. Dr. Tamburrino has extensive experience utilizing AlloDerm® in implant-based breast reconstruction. To schedule a consultation, please don’t hesitate to contact our office today.

What Is an Acellular Dermal Matrix?

An acellular dermal matrix, such as AlloDerm®, is a soft tissue substitute that is derived from donated human skin tissue. To ensure that the matrix is acellular, or not at risk of rejection, the matrix undergoes a multi-step proprietary process to remove the epidermis (or outer layer of skin) and any cells that can lead to an antigenic or rejection response. The use of an acellular dermal matrix offers a number of advantages to tissue donation from the patient’s body, as it eliminates skin graft and harvesting surgery, produces consistent results, and is available in multiple sizes and thicknesses to meet the specific needs of the patient.

AlloDerm® - An Integral Part of Implant Breast Reconstruction

The patented acellular dermal matrix AlloDerm® was created by LifeCell™ in 1994 as a type of graft material for the management of burn wounds. When surgeons use AlloDerm® in the body, it becomes incorporated into tissue, utilizing the body’s own regenerative power. In this way, AlloDerm® has the potential to help restore body tissue damaged through injury. Since its introduction, AlloDerm® has been used for various applications in reconstructive surgery including head and neck reconstruction as well as chest and abdominal wall reconstruction. Today, AlloDerm® has become an integral part of implant breast reconstruction, used in staged expander implant reconstruction, direct-to-implant reconstruction and revision procedures in breast reconstruction.

In the expander implant breast reconstruction technique, a pocket is created beneath the pectoralis major muscle, so that a tissue expander can be placed. However, since the pectoralis muscle only covers and supports the part of the expander in the front of the reconstructed breast, the lower and outer aspects of the expander need additional muscles to provide coverage. AlloDerm® can be used for this purpose, potentially avoiding the need for use of any muscle other than the pectoralis muscle. As healing occurs, the AlloDerm® becomes incorporated into the undersurface of the skin of the reconstructed breast, offering support and helping better define the breast contour. For patients undergoing direct-to-implant breast reconstruction, an implant is immediately placed under the pectoralis muscle, and the AlloDerm® is utilized in the same way, providing coverage and support along the lower and outer part of the reconstructed breast. For both the expander implant and the direct-to implant approaches, AlloDerm® assists in soft tissue coverage of the device where the pectoralis muscle cannot reach. In recent years, AlloDerm® has been successfully used not only for immediate breast reconstruction, but also for revision procedures to help correct problems related to capsular contracture and implant malposition.

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