Acellular dermis-assisted breast reconstruction.
BACKGROUND
In 2004, the authors reported their findings with placement of tissue expanders for breast reconstruction in the partial submuscular position, the equivalent of the "dual-plane" technique for breast augmentation. Limitations with subpectoral expander placement include difficulty controlling the lower pole of the pocket during expansion, unprotected device coverage by a thin inferior mastectomy flap, possible effacement of the inframammary fold, and limited control over the superior migration of the pectoralis major muscle. This study aimed to examine the safety and efficacy of an acellular dermal sling in providing inferolateral support to the device during immediate breast reconstruction and expansion.


METHODS
This study prospectively investigated 58 breasts of 43 consecutive women who underwent immediate breast reconstruction with tissue expanders and acellular dermis. After completion of adjuvant therapy and expansion, the devices were exchanged for implants. The patients were tracked through January, 2007. The study parameters included demographic information, oncologic data, complications, and aesthetic outcomes.


RESULTS
The mean time required to complete reconstruction was 8.6 months. The overall complication rate after expander/acellular dermis placement was 12%, whereas the complication rate after exchange to implants was 2.2%. The aesthetic outcome for reconstructed breasts did not differ significantly from that for the control subjects who had no surgery.


CONCLUSIONS
Acellular dermis appears to be a useful adjunct in immediate prosthetic breast reconstruction. Acellular dermis-assisted breast reconstruction has a low complication rate, helps to reconstruct an aesthetically pleasing breast, and facilitates expeditious completion of the reconstruction.
Spear
S L
SL
Department of Plastic Surgery, Georgetown University, 1st Floor PHC Building, 3800 Reservoir Road NW, Washington, DC 20007, USA.
Parikh
P M
PM
Reisin
E
E
Menon
N G
NG
D000328:Adult; D000368:Aged; D001940:Breast / Q000601:surgery*; D018427:Breast Implants; D020405:Dermis / Q000637:transplantation*; D005260:Female; D006801:Humans; D008408:Mastectomy; D008875:Middle Aged; D011446:Prospective Studies; D019651:Plastic Surgery Procedures / Q000379:methods*; D015625:Tissue Expansion Devices; D014184:Transplantation, Homologous