AlloDerm Versus Cortiva: A Multicenter Pooled Analysis of Clinical and Economic Outcomes in Breast Reconstruction

AlloDerm and Cortiva are 2 commonly used human acellular dermal matrices for prosthetic breast reconstruction, yet their comparative clinical performance remains uncertain. The objective of this study is to systematically compare short-term clinical outcomes, patient-reported physical well-being, and perioperative resource use among AlloDerm and Cortiva in immediate or delayed prosthetic breast reconstruction.

A systematic search of PubMed, Scopus, and Web of Science (from inception to June 15, 2025) identified comparative studies of AlloDerm versus Cortiva. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines were followed. Studies were included if they provided comparative data on complications, BREAST-Q scores, or costs. Random-effects meta-analyses were used to estimate mean differences for continuous variables and odds ratios for binary outcomes. Heterogeneity was quantified with the I² statistic. Cost data (reported heterogeneously) were summarized narratively.

Five studies (1 blinded randomized trial, 1 small interim randomized controlled trial, and 3 propensity-matched or retrospective cohorts) comprising 1180 breast reconstructions in 1072 patients met the inclusion criteria. Across all endpoints, no statistically significant differences were observed between the 2 acellular dermal matrices in terms of complication rates or BREAST-Q scores. Four studies presented cost information. Two detailed economic evaluations showed that the acquisition price of Cortiva was 10%-22% lower per sheet and translated into a 44%-56% reduction in total per-breast episode cost when operative and complication-related expenses were included.

Current evidence shows no clear difference between AlloDerm and Cortiva in terms of clinical outcomes but identifies a potential cost advantage for Cortiva. Pending long-term data, Cortiva represents the more economical choice.