Semin Plast Surg 2019; 33(04): 229-235
DOI: 10.1055/s-0039-1696986
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Evidence for the Use of Acellular Dermal Matrix in Implant-Based Breast Reconstruction

Paula R. Gravina
1  Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
,
Rowland W. Pettit
1  Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
,
Matthew J. Davis
1  Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
,
Sebastian J. Winocour
1  Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
,
Jesse C. Selber
2  Department of Plastic Surgery, The University of Texas, MD Anderson Cancer Center, Houston, Texas
› Author Affiliations
Further Information

Publication History

Publication Date:
17 October 2019 (online)

Abstract

Acellular dermal matrices (ADMs) are tissue grafts that have been specially processed to remove all cellular components. These machined biological scaffolds have become popular in a variety of surgical settings due to their rapid incorporation into living tissue. As ADMs are highly malleable and cause minimal inflammation, they have come to serve as a useful tool in implant-based breast reconstruction procedures. The major benefits of using an ADM in this setting include superior initial breast contouring, decreased risk of capsular contracture after implant insertion, and consistent sustained positioning of the reconstructed breast. Despite these advantages, these tissue grafts are foreign to the host, and postoperative complications following ADM insertion, including infection and seroma, have been well documented. When considering using ADMs in this setting, it is important to first consider patient-specific factors that could preclude their use, such as low body mass index, small breasts, or a history of radiation exposure to the breast tissue. ADM grafts are also expensive, which may present another barrier to their use. Review of the literature ultimately suggests a continued role for ADMs in implant-based breast reconstruction, and continued research in this field is warranted.

Disclosures

None of the authors of this manuscript have a financial interest in any of the products, devices, or drugs mentioned herein.