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Breast Reconstruction Postmastectomy
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 AlloDerm- Coverage, support, and stabilization of implant/expander in immediate breast reconstruction
Prosthetic breast reconstruction with implant or expander is a current standard in immediate breast reconstruction postmastectomy. A key issue with this surgical technique is attaining adequate pectoralis major muscle coverage of the implant/expander such that the prosthesis is held in place within the mastectomy pocket. Muscle loss during mastectomy and the poor quality of the remaining muscle could preclude extending the muscle over the prosthesis and securing it at the lower breast pole. Current options to supplement the muscle deficiency include the transfer of autologous tissue from the 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.
The strength and flexibility of AlloDerm, as well as its ability to resist infection and rejection and to support regeneration into viable tissue that minimize scarring and fibrosis, makes it an excellent tissue substitute at the lower breast pole. The surgical technique using AlloDerm at the lower breast pole:
Defines the shape and contour of reconstructed breast- By supporting and holding the prosthesis in place, AlloDerm also helps to define the shape and contour of the reconstructed breast, thereby contributing to improved cosmesis.
- Additionally, 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.
Recreates a well-defined inframammary fold and lateral mammary fold- During mastectomy, the inframammary fold (IMF) and the lateral mammary fold (LMF), which define the inferior and lateral borders of the breast, respectively, could be disrupted or destroyed. Traditionally, the LMF is recreated using the serratus anterior muscle. AlloDerm placed along the lower breast pole could be used to recreate both the IMF and LMF. The use of AlloDerm, therefore, can obviate the need to elevate the serratus muscle.
Minimizes morbidity 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.
Improves 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.2
Optimizes outcomes without increased risk for complications
When used for breast reconstruction, AlloDerm should not be stretched intra-operatively, as its laxity may be used to accommodate the increased volume of the expander/implant.
Product Specifications
| Product Code | Nominal Size | Thickness** | | 102050 | 4 x 12 cm | Thick | | 982048 | 4 x 12 cm | X-Thick | | 102082 | 4 x 16 cm | Thick | | 982080 | 4 x 16 cm | X-Thick | | 102072 | 6 x 12 cm | Thick | | 982070 | 6 x 12 cm | X-Thick |
**Thick: 0.79 - 2.03 mm (0.031 - 0.080 inches)
**X-Thick: 2.06 - 3.30 mm (0.081 - 0.130 inches)
Larger sizes may be available upon request
Your LifeCell representative can help with the correct selection. To order AlloDerm, click here or call our toll-free LifeCell Customer Support Line at 800-367-5737.
References:
- Spear SL et al. Regenerative human acellular tissue matrix (AlloDerm®) as tissue supplement in immediate breast reconstruction postmastectomy - A technical perspective. LifeCell Clinical Monograph Series, 2005.
- Salzberg CA. Non-expansive breast reconstruction with human acellular tissue matrix (AlloDerm®). Poster presented at the 27th San Antonio Breast Cancer Conference, December 8-11, 2004.
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