In this study the authors present a review of their experience in using Acellular Dermal Matrix (AlloDerm) in revision breast reconstruction procedures. They retrospectively reviewed all revisional breast reconstruction cases over a five-year period in which AlloDerm had been utilised. This included 154 breast reconstruction revisions in 118 patients carried out by a single surgeon. The indications for use of AlloDerm in the revision procedures were: inframammary fold (IMF) malposition, capsular contracture (III/IV), inferior pole support, medial fold support / symmastia and rippling / palpability of previous implant. The average follow-up was 207 days (range 41 days to six years). In the follow-up period significant capsular contracture (III/IV) was noted in five breasts, failure to lower the IMF was seen in one breast, persistent rippling was noted in one breast and one breast reconstruction infection occurred. This resulted in an overall complication rate of 5%. The study is limited by a relatively short mean follow-up period in terms of capsular contracture rates and by the fact that the authors fail to explain in their methodology the assessment process of their pre and postoperative results in terms of improving IMF position (the largest indication for revisional surgery in this study).

Use of acellular dermal matrices in revisional breast reconstruction.
Spear SL, Sher SR, Al-Attar A, Pittman T.
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Adam Gilmour

St John's Hospital, Livingston, UK.

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