The use of human acellular dermal matrix for the correction of secondary deformities after breast augmentation: results and costs.
BACKGROUND
Secondary breast deformities following breast augmentation constitute some of the most challenging and difficult problems to correct. Although the application and efficacy of human acellular dermal matrix in breast reconstruction has been previously reported, there is little information in the literature relating to its indications, results, or cost in aesthetic breast surgery.


METHODS
This study retrospectively reviewed a single surgeon's experience in correcting secondary deformities with human acellular dermal matrix after breast augmentation from 2005 to 2009. A total of 23 patients (38 breasts) were included in the study.


RESULTS
There were 28 breasts with surface irregularities and 22 breasts with implant malposition (12 had both). On average, 1.13 sheets of human acellular dermal matrix were used per breast per operation. At the authors' institution, this material equates to a cost to the patient of $3536 to $4856 per breast (depending on sheet size and thickness). Twenty of 23 patients (87 percent) [32 of 38 breasts (84 percent)] had improvement in their breast deformity after breast revision surgery. Three patients (six breasts) needed another cosmetic breast operation before the end of the follow-up period: two because of persistent surface irregularities and one with a request for larger implants. One patient (3 percent) had an infection in one breast, requiring removal of the human acellular dermal matrix.


CONCLUSIONS
Human acellular dermal matrix is a useful and safe adjunct for correction of contour deformities after breast augmentation. Its high cost, however, may be a deterrent to widespread use in self-pay patients.
Boston, Mass. From the Divisions of Plastic Surgery of Brigham and Women's Hospital and Beth Israel Deaconess Medical Center, Harvard Medical School.
Tristan L
TL
Hartzell
Amir H
AH
Taghinia
Jerry
J
Chang
Samuel J
SJ
Lin
Sumner A
SA
Slavin
D000328:Adult; D000368:Aged; D001672:Biocompatible Materials / Q000008:administration & dosage*; D019928:Breast Implantation; D003094:Collagen / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000009:adverse effects*; D008875:Middle Aged; D012086:Reoperation; D055815:Young Adult
C440568:Alloderm; D001672:Biocompatible Materials; D003094:Collagen