Expander/Implant Reconstruction with AlloDerm: Recent Experience

Abstract

Acellular dermal matrix augmentation of the pectoralis major muscle in the setting of prosthetic breast reconstruction improves the soft-tissue drapery around devices without resorting to additional muscle or fascial flaps. Total device coverage and precise control of the pocket dimensions permit more predictably superior results in these patients.

The Effect of Acellular Dermal Matrix in Implant-Based Immediate Breast Reconstruction with Latissimus Dorsi Flap.

“…Less capsular contracture (0-4%) recently has been reported by multiple clinical studies with the use of acellular dermal matrix in implant-based breast reconstruction [6][7][8][9][11][12][13][14]. This is a great improvement over reported capsular contracture rates of 10 to 20% in traditional reconstructions without acellular dermal matrix [15], strongly suggesting that matrix may have the potential ability to mitigate the risk of capsular contracture.…”

“…Using acellular dermal matrix provides a better aesthetic outcome in various studies [6,11] but the most of them are the personal opinions of the authors upon reflection of their outcomes and their patients' perceptions of their outcomes. Spear et al [9] only performed the systematic analysis of the aesthetic outcome of reconstructed breast with implant and acellular dermal matrix compared with contralateral unreconstructed breast.…”

“…Although acellular dermal matrix-assisted reconstruction is not novel [11], there is limited information on the use of acellular dermal matrix in breast reconstruction with implant and latissimus dorsi flap, widely applicable with a high degree of satisfaction among the patients and few functional repercussions [16], specifically focused on capsular contracture reduction.…”

Does Veritas® play a role in breast reconstruction? a case report

“…The aforementioned patient selected for the bovine pericardium collagen matrix patch exhibited the ideal characteristics for reconstruction with Alloderm ® ; in fact according to the study of Namnoun, 5 the best candidates for using Veritas ® are: those with juvenile tight breasts, those needing immediate bilateral reconstruction, those requiring nipple-or skin-sparing mastectomy, and those not requiring complementary radiotherapy. The Veritas ® bovine pericardium patch was licensed by the British Standard Institution in October 2009 and it has been introduced throughout the European Union, while for now a main obstacle to Alloderm ® distribution in Europe is that it requires a country-by-country approval.…”

Acellular Dermal Matrix for Optimizing Outcomes in Implant-Based Breast Reconstruction: Primary and Revisionary Procedures

“…More recently, ADMs have been used at the inferolateral pole after capsulotomy or capsulectomy to help correct and prevent capsular contracture (Breuing & Colwell, 2007;Hartzell et al, 2010;Spear et al, 2011). In ADM-assisted implant-based primary reconstructions, a low rate of capsular contracture (0%-2%) has been observed (S. Becker et al, 2009;Bindingnavele et al, 2007;Breuing & Colwell, 2007;Namnoum, 2009;Salzberg, 2006;Salzberg et al, 2011;Spear et al, 2008;Zienowicz & Karacaoglu, 2007), suggesting that ADMs may help prevent or reduce the risk of capsular contracture; hence, the rationale for using ADMs for the correction and prevention of capsular contracture. Animal and clinical studies suggest that ADMs may prevent capsular contracture by minimizing the inflammatory response, thereby reducing capsule formation around implants (Basu et al, 2010;Komorowska-Timek et al, 2009;Orenstein et al, 2010;Stump et al, 2009;Uzunismail et al, 2008).…”