title: Efficacy of acellular dermal matrices in revisionary aesthetic breast surgery: a 6-year experience.
abstract: BACKGROUND
  Augmentation mammaplasty and augmentation mastopexy are associated with a substantial primary and secondary revision rate. Capsular contracture (CC), implant malposition, ptosis, asymmetry, and rippling are the main reasons for revisionary surgery in these patients. Traditional corrective techniques have not been completely reliable in preventing or treating these complications. Recently, acellular dermal matrices (ADM) have been used to assist with revisionary surgery with promising results.
  
  
  OBJECTIVE
  The authors review their 6-year experience using ADM for revisionary surgery in aesthetic patients and evaluate long-term outcomes with this approach.
  
  
  METHODS
  Patients who underwent revisionary breast augmentation or augmentation mastopexy with ADM in conjunction with standard techniques over a 6-year period between October 2005 and December 2011 were retrospectively reviewed. Only patients with at least 1 year of follow-up were included in the analysis.
  
  
  RESULTS
  A total of 197 revisions were performed (197 patients). Reasons for revision included CC (61.8%), implant malposition (31.2%), rippling (4.8%), ptosis (4.8%), implant exposure (1.6%), and breast wound (0.5%). The mean ± SD follow-up period was 3.1 ± 1.1 years (range, 0.1-6.1 years). The complication rate was 4.8%, including Baker grade III/IV CC (1.6%), infection (1.6%), implant malposition (0.5%), hematoma (0.5%), and seroma (0.5%). Most (98%) revisions were successful, with no recurrence of the presenting complaint.
  
  
  CONCLUSIONS
  The use of ADM in conjunction with standard techniques for the reinforcement of weak tissue in revision augmentation and augmentation mastopexy patients appears to be effective.
authors: Department of Plastic Surgery, Loma Linda University Medical Center, Loma Linda, California 92354, USA.
authors: G Patrick
authors: GP
authors: Maxwell
authors: Allen
authors: A
authors: Gabriel
mesh_terms: D062088:Acellular Dermis; D000328:Adult; D000368:Aged; D001940:Breast / Q000601:surgery*; D019928:Breast Implantation / Q000009:adverse effects; D004954:Esthetics; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000009:adverse effects* / Q000379:methods; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies; D016038:Skin Transplantation / Q000009:adverse effects / Q000379:methods; D013536:Suture Techniques; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult