The use of porcine acellular dermal matrix in silicone implant-based breast reconstruction

• Published in: Archives of gynecology and obstetrics 2012-07, Vol.286 (1), p.187-192
• Main Authors: Himsl, I., Drinovac, V., Lenhard, M., Stöckl, D., Weissenbacher, T., Dian, D.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Animals; Biocompatible Materials; Breast cancer; Breast Implants - adverse effects; Breast Neoplasms - surgery; Endocrinology; Esthetics; Female; Gynecologic Oncology; Gynecology; Human Genetics; Humans; Mammaplasty - adverse effects; Mammaplasty - methods; Mastectomy; Medicine; Medicine & Public Health; Middle Aged; Obstetrics/Perinatology/Midwifery; Patient Satisfaction; Silicones; Skin & tissue grafts; Skin, Artificial; Swine; Tissue Scaffolds; Touch
• ISSN: 0932-0067; 1432-0711
• DOI: 10.1007/s00404-012-2266-x

Introduction The most frequently occurring long-term complication in implant-based breast reconstruction is fibrotic capsule formation at the recipient site, with concurrent dysesthesia and poor aesthetic results. Using porcine acellular dermal matrix (PADM) as a connective tissue graft material is supposed to improve the quality and quantity of soft tissue in implant-based breast reconstruction. This study investigates the indications for and the results and the costs of using PADM for the correction or prevention of implant-associated breast deformities. Materials and methods This study reviewed a single surgeon’s experience in the correction or prevention of implant-associated breast deformities with PADM in breast cancer-related breast reconstruction from 2009 to 2011. A total of 23 patients (27 breasts) were included in the study. The aesthetic outcome, the incidence and the type of complication were analysed. Twenty-three women underwent breast cancer-related breast reconstruction: 19 women underwent single-breast reconstruction and four women underwent bilateral reconstruction. Results Of the 23 patients who underwent breast reconstruction, 18 (78%) were “satisfied” with the aesthetic and haptic outcome after implant-based reconstruction with PADM. One patient (one breast) required another breast operation because of ipsilateral breast cancer recurrence during the follow-up period. PADM-assisted implant-based breast reconstruction has a satisfactory safety profile. Conclusion The use of PADM as an interface matrix for implant-based breast reconstruction yielded predictable and acceptable aesthetic and haptic results by preventing capsular contracture, rippling, implant malposition, soft-tissue thinning and failure of the silicone implant-based breast augmentation.