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CC BY 4.0 · Revista Brasileira de Cirurgia Plástica (RBCP) – Brazilian Journal of Plastic Surgery 2025; 40: s00451811236
DOI: 10.1055/s-0045-1811236
Artigo Original

Use of Acellular Dermal Matrix in the Treatment of Capsular Contracture after Radiotherapy

Article in several languages: português | English

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Financial Support The authors declare that they did not receive financial support from agencies in the public, private, or non-profit sectors to conduct the present study. Clinical Trials None.
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Abstract

Introduction

In Brazil, breast cancer is the most common neoplasm after non-melanoma skin cancer. Radiotherapy increases breast reconstruction complications, including severe capsular contracture. Studies indicate that acellular dermal matrix (ADM) can prevent this complication, reducing local inflammation because it is not recognized as a foreign body.

Materials and Methods

In the present prospective study, we evaluated patients with breast cancer who underwent mastectomy with immediate reconstruction using silicone implants or expanders and radiotherapy and developed Baker grade-III or -IV capsular contracture, who underwent a new surgery for treatment. We divided the patients into two groups: group 1 (G1) underwent conventional therapy consisting of capsulotomy and fat grafting without ADM, while the treatment for group 2 (G2) involved ADM and fat grafting.

Results

The study included 76 patients, 56 in G2 and 20 in G1. The evaluation considered objective (inframammary fold height, nipple-areola complex height, and the number of surgeries) and subjective (volume, consistency, and Baker grade of contracture) measurements of the reconstructed breast compared with the contralateral breast. There were statistically significant differences between the groups. Mild contractures occurred in 82.1% of G2 and in 30% of G1. We observed deforming contractures in 0% of G2 and in 50% of G1 (p < 0.001).

Conclusion

In patients with postradiotherapy capsular contracture, ADM with fat grafting reduces the lesion and provides better esthetic and functional outcomes compared with the conventional treatment with capsulotomy and fat grafting.

Keywords

acellular dermis - breast neoplasms - implant capsular contracture - mammaplasty - radiotherapy


Publication History

Received: 17 December 2024

Accepted: 20 May 2025

Article published online:
15 October 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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Bibliographical Record
Marcela Caetano Cammarota, Saulo Francisco de Assis Gomes, Igor Moura Soares, Diogo Borges Pedroso, Lucas Albuquerque de Aquino, Jefferson Di Lamartine Galdino Amaral. Uso de matriz dérmica acelular no tratamento de contratura capsular após radioterapia. Revista Brasileira de Cirurgia Plástica (RBCP) – Brazilian Journal of Plastic Surgery 2025; 40: s00451811236.
DOI: 10.1055/s-0045-1811236
 

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