Summary: Acellular dermal matrix (ADM) offers several significant benefits for breast surgery patients. Acellular dermal matrix is a layer of tissue constructed from skin or other materials from which the cells have been removed while leaving the extracellular matrix intact. This provides surgeons with a sterile foundation for new cells to grow into and eventually replace. The technique was originally developed as an adjunct to skin grafts for burn patients, but has since proven to have more far-reaching benefits in plastic and reconstructive surgery, particularly when it comes to breast enhancement or reconstructive surgery.
1. Adds Strength to Surgical Pocket
When implants are used in breast augmentation and breast reconstruction, the strength of the surgical pocket can affect not only the quality of the end cosmetic result of surgery, but also the longevity of the results. Implant pockets that are weak are more likely to expand or shift position entirely, potentially displacing the implant. This is a particular risk in breast reconstruction after a mastectomy when there may be little existing tissue to firmly support an implant. By using ADM to create a framework upon which tissue can regrow and strengthen, the surgical pocket can maintain a more reliable position, holding the implant firmly in place.
2. Prevents Visible Surface Rippling
Visible surface rippling is a particular risk with saline implants and with patients who have little to no pre-existing breast tissue to cover the implant. While ADM is typically used to structure the implant pocket, surgeons can also use the innovative technique of replacing soft tissue to cover the implant with an additional layer. This may resolve issues of rippling for patients without natural tissue to cover saline or even silicone implants. Additionally, ADM as an implant-covering layer can also prevent implants from being extruded, when the implant becomes exposed through the skin, normally at the site of an incision, or textural palpability, when the shape of the implant can be clearly felt through the skin.
3. Can Be Used During Implant Revision to Keep Implants Properly Placed
Implant displacement is one of the most common reasons women with implants undergo breast revision surgery. Synmastia (implants moving too close together), lateral displacement (implants moving too far apart), and bottoming out (implants sliding too far down) are all different types of implant displacement. Displacement requires surgical correction and can result in an unnatural breast appearance. By using ADM to improve and strengthen the implant pocket, surgeons can help ensure that implants remain properly placed following breast surgery. Improved control of the implant position also means that reconstructed breasts may have a greater potential for adopting a natural degree of ptosis, resulting in higher quality aesthetic results.
4. May Help Limit Occurrence of Capsular Contraction in Breast Reconstruction
Capsular contracture, the excessive hardening of scar tissue surrounding an implant, can cause implants to feel unnaturally hard and even sore to the touch and requires revision surgery to correct. In a recent study, researchers concluded that using ADM to fully cover the outside of the implant at the time of insertion may effectively treat capsular contracture and prevent recurrence. The apparent resistance of ADM to capsular contracture could have significant value for plastic and reconstructive surgeons who are constantly searching for ways to reduce the chance of patients developing post-surgical complications.