title: Non-cross-linked porcine acellular dermal matrix in revision breast surgery: long-term outcomes and safety with neopectoral pockets.
abstract: BACKGROUND
  Revision breast surgery represents a significant problem among patients who have undergone augmentation mammaplasty. Current techniques do not adequately prevent recurrence, thus requiring novel approaches, including placement of Strattice (LifeCell, Branchburg, New Jersey), a non-cross-linked porcine acellular dermal matrix, to minimize recurrence.
  
  
  OBJECTIVE
  The authors review their experience and long-term outcomes with placement of Strattice in revision breast surgery patients who underwent previous augmentation mammaplasty.
  
  
  METHODS
  All patients in the authors' practice with a previous history of augmentation mammaplasty who underwent revision breast surgery with placement of Strattice between January 2007 and December 2011, and who had a minimum of 12 months of follow-up, were included in this retrospective study. A total of 106 patients met the study's inclusion criteria.
  
  
  RESULTS
  Average patient age was 42.3 years and average follow-up time was 3.1 years. Indications for revision surgery included capsular contracture (51.9%), implant malposition (38.7%), and ptosis (8.5%); approximately 40% had ≥1 previous attempts to correct the presenting complaint. Revision surgery included creation of neosubpectoral pockets with retention of previous noncalcified capsules in 81% of patients with subpectoral implants. Presenting complaints were successfully resolved in all patients. The overall complication rate was 0.9%.
  
  
  CONCLUSIONS
  Adding Strattice to traditional revision surgery procedures results in reliable, durable repair of the presenting complaint with minimal associated complications. Treatment with Strattice in conjunction with noncalcified capsules retained during site change also appears to be safe. The data support a role for Strattice in revision breast surgery for patients who have undergone previous augmentation mammaplasty.
authors.affiliation: Department of Plastic Surgery, Loma Linda University Medical Center, Loma Linda, California.
authors.forename: G Patrick
authors.initials: GP
authors.lastname: Maxwell
authors.forename: Allen
authors.initials: A
authors.lastname: Gabriel
mesh_terms: D062088:Acellular Dermis; D000328:Adult; D000368:Aged; D001940:Breast / Q000601:surgery*; D019928:Breast Implantation / Q000009:adverse effects*; D003094:Collagen / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: C568444:strattice; D003094:Collagen
keywords: Strattice; breast revision surgery; capsular contracture; implant malposition; mastopexy; porcine acellular dermal matrix; ptosis; revision augmentation; rippling