Breast reconstruction with
an implant and or an expander is the current standard in immediate breast
reconstruction post mastectomy. The central issue with this surgical
technique is attaining adequate
pectoralis major muscle coverage of the
implant/expander. This is very important as this will help the prosthesis
to be held in place within the pocket that is made for the implant to sit in.
reconstruction after a mastectomy can sometimes yield some muscle loss and or
the quality of the muscle is not enough to cover the prosthesis. There has
to be sufficient coverage so that the prosthesis is secured in the lower pole
area of the breast.
Current options to
supplement the muscle deficiency include the transfer of autologous tissue from
latissimus dorsi, the elevation of the external oblique muscle together with
its rectus abdominus fascia for implant coverage, or the elevation of the
serratus anterior muscle for lateral implant coverage. All of these options
introduce further morbidity and, in the case of the latissimus tissue, has the
added disadvantage of donor site complications.
Coverage - support - stabilization of implant/expander in immediate breast reconstruction
Alloderm shapes and
contours the reconstructed breast:
By supporting and holding the prosthesis in place, AlloDerm also helps to
define the shape and contour of the reconstructed breast, contributing to improved overall cosmetic look.
AlloDerm provides reinforcement to the mastectomy skin envelope; this avoids
direct contact of the mastectomy skin envelope with the implant/expander.
Direct skin envelope - prosthesis contact could lead to implant exposure if
skin loss occurs.
Alloderm reconstructs a
defined inframammary fold and lateral mammary fold:
During mastectomy, the inframammary fold and the lateral mammary fold, which
define the inferior and lateral borders of the breast - could be disrupted
or destroyed. The lateral mammary fold is recreated using the serratus
AlloDerm placed along the lower breast pole can be
used to recreate both the inframammary fold and the lateral mammary fold.
disease states by simplifying the procedure:
By eliminating the need to elevate the serratus anterior and the external
oblique muscles and the
rectus abdominus fascia for implant/expander
coverage, AlloDerm not only reduces morbidity, but it also simplifies
immediate breast reconstruction
Alloderm can improve
greatly the aesthetic outcome and patient satisfaction:
Good breast projection and symmetry between breasts, achieved in a series of
40 implant reconstructions, have been attributed to the use of AlloDerm and
patients were satisfied with the surgical result.
improve outcomes without increased risk for complications:
Alloderm used during breast reconstruction, should not be stretched
intra-operatively, as its laxity may be used to accommodate the increased
volume of the expander/implant.