AlloDerm is an FDA-approved, patented tissue matrix, firstly introduced in 1994 by LifeCell as a graft for burns. Since then, due to its unique versatility, it's used in a number of other reconstructive surgeries, such as facial or abdominal wall restoration, and lately, breast reconstruction, otherwise known as a mastectomy.
AlloDerm offers plastic surgeons the ability to restore various types of damaged tissue caused by radiation, injury or disease by exploiting the extraordinary regeneration capacity of the human body.
For a large number of patients, a mastectomy is part of their breast cancer treatment. Breast removal may affect some deeply, and not only physically but psychologically, too. Breast reconstruction is an integral and vital part of the surgical treatment of breast cancer because it contributes to both the physical and psychological rehabilitation of the patient, and consequently, to the improvement of their quality of life.
Nowadays, there are various methods available to restore breast tissue after undergoing a mastectomy. The technique used depends on an individuals' body characteristics; chest wall; the breast size; the sufficiency of tissues in the anterior chest wall; whether or not the patient has undergone radiotherapy; the general condition of the patient; age; and any specific desires.
How is AlloDerm Produced?
AlloDerm matrix tissue is developed by a specific multi-step process from donated human skin. All the cells are removed from the provided skin without eliminating the skin's vital biochemical and structural components. Although the skin is donated, AlloDerm is a tissue material without human cells and has a low risk of rejection. In fact, AlloDerm practically serves as a framework where the patient’s own cells grow into it.
However, as skin is donated, some patients and surgeons may worry that it might carry harmful viruses. The truth: there's never been any reported viral disease transmission to any patient from over a million restoration procedures so far; proving AlloDerm is a safe product.
Each donated tissue is screened for communicable diseases, and medical directors check the medical record of every donor prior to processing. All donors must be negative for syphilis, hepatitis B and C, and HIV 1 and 2. Moreover, all grafts are examined under a microscope before and after processing to exclude contamination.
What Makes Someone the Best Surgical Candidate for AlloDerm?
Like all surgical interventions, the key to achieving the best results is to be the perfect candidate. AlloDerm could be a good choice for any person who is suitable for tissue expander or implant-based reconstruction; especially for those with medium- or large-sized breasts who need to undergo bilateral breast reconstruction surgery.
Ideal candidates also, given that they have mastectomy flaps with good blood supply, are people with small breasts undergoing reconstruction in one of their breasts or those who will undergo single breast reconstruction and desire a larger cup size with a contralateral balancing breast augmentation. (Learn more about these 8 Things You May Not Know About Breast Augmentation.)
However, there are cases where AlloDerm isn't a good option. Generally, as in many operations, obese people with large breasts are poor candidates. Moreover, patients with excessive mastectomy flap, even with significant flap trimming and substantial implant fill volume, usually form a large dead space above the matrix tissue.
This results in the collection of clear serous fluid and delayed formation of blood vessels in the AlloDerm, increasing the risk of complications. Lastly, people with poor blood supply of the flaps have a higher risk of side effects with AlloDerm.
What Are the Advantages of Using AlloDerm?
Using AlloDerm allows plastic surgeons to restore the patient's breasts, offering a natural look and positive feeling than conventional breast implant reconstruction methods. This can be achieved, as the matrix tissue:
- Creates an “internal bra” which acts as a hammock that supports the implant and, thus, keeps it in the desired place, preventing relevant problems such as the merge of the breasts across the breastbone or bottoming out of the implant.
- Allows the plastic surgeon to have better control of the implant position which is really helpful for obtaining the desired breast shape and size
Furthermore, AlloDerm tissue matrix minimizes the possibility to develop extra problems that could occur with breast reconstruction surgery.
Besides first stage breast reconstruction, AlloDerm has found numerous uses in secondary restoration. For example, it can be used in revision surgeries to help cover any implant rippling and to help repair any implant malposition. In addition, it may be used for the nipple reconstruction. (Learn more with A Comprehensive Guide to Nipple Reduction Surgery.)
Other advantages include:
- Offers complete coverage of the implant, masking any visibility through the skin.
- Gives the possibility to create a full-sized breast when the tissue expander/implant reconstruction and the mastectomy are performed at the same time.
- Eliminates the risk of rejection.
- As soon as it is incorporated by the body, it is resistant to infections likewise any other patient’s natural tissue.
What Are the Disadvantages of Using AlloDerm?
Like any intervention, AlloDerm has some disadvantages, too.
- Similar to any foreign material that's implanted, there's an initial low risk of infection until the complete incorporation of the tissue.
- Some patients may experience some limited redness in the skin over the AlloDerm (“red breast syndrome”) that usually goes away soon after surgery.
- AlloDerm is expensive; however, its cost is usually covered by approved medical insurance.
Reconstructive Surgery Recovery
After surgery, the plastic surgeon places some tiny tubes in order to help the excess fluid and blood to drain. Those drains usually remain in place for 7-10 days. Lastly, routine postoperative antibiotic prophylaxis is administered to prevent infection.
The use of AlloDerm in many surgical procedures, including breast reconstruction, has increased spectacularly over the last few years. Without a doubt, the expander/implant reconstruction surgery can be performed with great success with the conventional methods, too. Yet, the development of matrix tissues has offered an innovative tool to plastic surgeons with which lasting, predictable results can be easily achieved.