The Use of Human Acellular Dermal Matrix for the Correction of Secondary Deformities after Breast Augmentation: Results and Costs

Abstract

Human acellular dermal matrix is a useful and safe adjunct for correction of contour deformities after breast augmentation. Its high cost, however, may be a deterrent to widespread use in self-pay patients.

Macrophage phenotypes correspond with remodeling outcomes of various acellular dermal matrices

“…These products are all composed of extracellular matrix (ECM) but differ in species of origin, tissue source, processing methods and/or extent of chemical crosslinking. They have been used for a number of applications, first with burns [1,2], but more recently with cosmetic [3,4] and reconstructive procedures [5,6], notably breast reconstruction [7,8].…”

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

“…The feasibility of using ADM for the correction of visible implant rippling and breast deformities due to implant malposition was initially reported almost a decade ago in breast reconstruction and aesthetic patients (Baxter, 2003;Duncan, 2001). Since then several studies have demonstrated a significant reduction in recurrence and improved cosmesis with the use of ADM for the correction of capsular contracture, implant malposition, and rippling (Breuing & Colwell, 2007;Grabov-Nardini et al, 2009;Hartzell et al, 2010;Spear et al, 2011). Overall, > 87% of implant-related complications were successfully managed using ADMs.…”

“…However, capsular flaps have limited applicability in patients with attenuated capsules who are unlikely to have adequate tissue. As an alternative to capsular flaps, recent studies have advocated the use of ADM to reinforce the capsulorrhaphy suture line and maintain the implant within its pocket Hartzell et al, 2010;Spear et al, 2011). In addition, the use of ADM also helps to redefine the IMF and LMF.…”

“…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). Published series have reported successful correction of > 90% of grade 3/4 capsular contractures with the use of ADMs with no recurrences during a mean follow-up period of 9-21 months (Breuing & Colwell;Hartzell et al, 2010;Spear et al, 2011).…”