The Role of Acellular Dermal Matrices in Capsular Contracture

Abstract

Despite advances in breast implant surgery, capsular contracture remains a challenging sequela of reconstructive and cosmetic breast implant surgery. Although there are established modalities for treatment, most recently, acellular dermal matrix products have been suggested to have a role in preventing or diminishing the pathologic process of capsular contracture. In this article, the author presents a review of the literature to highlight the level of evidence on the role of acellular dermal matrices in the treatment of capsular contracture.

Comparison of Histological Characteristics of Acellular Dermal Matrix Capsules to Surrounding Breast Capsules in Acellular Dermal Matrix–Assisted Breast Reconstruction

“…Some have proposed that the ADM inhibits the inflammatory process inherent in the pathogenesis of capsular contracture. 14 Few studies have investigated the histological profile of ADM. The first detailed comparison between breast capsules containing ADM and the surrounding native capsule was published by Basu et al in 2010.…”

Prevention of Capsular Contracture with Photochemical Tissue Passivation

“…24 This may also explain recent findings that acellular dermal matrices can decrease the rate of capsular contracture when placed adjacent to an implant. 25 Photochemical cross-linking of collagen scaffolds has also been found to reduce both platelet adhesion and fibrin mesh formation. 26 This type of passivation would be of certain benefit in the inflammatory milieu of the implant pocket.…”

Regenerative Biomaterials

“…In addition, there is some evidence that acellular dermal matrix can reduce the incidence of capsular contracture, although this is still disputed, with most studies being case series, retrospective, noncomparative, and underpowered. 2,26,30,34,57 Biocompatibility is thought to account for the improved outcomes associated with acellular dermal matrix use. In a clinically relevant large-animal model of breast reconstruction, Garcia and Scott demonstrated histologically that acellular dermal matrix integrates into native tissue after 8 weeks, with good vascularization by week 12.…”