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Tissue Reinforcement in Implant-based Breast Reconstruction.
Michael Scheflan1, Amy S Colwell1
1Assuta and Herzlia Medical Centers, Tel Aviv, Israel; and Division of Plastic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Mass.
Plastic and Reconstructive Surgery. Global Open
|November 27, 2014
Summary
Acellular dermal matrices (ADMs) enhance breast reconstruction outcomes by improving aesthetics and facilitating direct-to-implant procedures. Careful patient selection and surgical technique are key to minimizing complications with ADM use.
Area of Science:
- Plastic Surgery
- Reconstructive Surgery
- Biomaterials
Background:
- Acellular dermal matrices (ADMs) are increasingly utilized in breast reconstruction.
- ADMs facilitate both single-stage (direct-to-implant) and two-stage implant-based breast reconstruction.
- They offer advantages in implant positioning and obviate submuscular placement.
Purpose of the Study:
- To review the benefits and risks associated with ADM use in implant-based breast reconstruction.
- To analyze available data on ADM efficacy and safety.
- To provide insights based on institutional experience.
Main Methods:
- Comprehensive literature analysis with a focus on recent publications.
- Inclusion of institutional experience for practical guidance on ADM application.
Main Results:
- ADMs can improve breast definition and lower pole projection, potentially enhancing aesthetic outcomes.
- ADM use may facilitate direct-to-implant reconstruction.
- Complication rates with ADMs remain debated, though considered safe in selected patients.
- ADMs show promise in managing and potentially reducing capsular contracture.
- Emerging synthetic/biosynthetic alternatives offer options to avoid human/mammalian tissue products.
Conclusions:
- ADM-assisted breast reconstruction can yield improved aesthetic results.
- Success hinges on meticulous patient selection, surgical technique, and postoperative care.
- Minimizing complications requires careful consideration of patient-specific risk factors.
