Sterile Acellular Dermal Collagen as a Treatment for Rippling Deformity of Breast

Brittany Busse,Hakan Orbay,David E Sahar

doi:10.1155/2014/876254

Abstract

Prosthetic implants are frequently used for breast augmentation and breast reconstruction following mastectomy. Unfortunately, long-term aesthetic results of prosthetic breast restoration may be hindered by complications such as rippling, capsular contracture, and implant malposition. The advent of use of acellular dermal matrices has greatly improved the outcomes of prosthetic breast reconstruction. We describe a case of rippling deformity of breast that was treated using an acellular dermal matrix product, AlloMax. The patient presented with visible rippling of bilateral prosthetic breast implants as well as significant asymmetry of the breasts after multiple excisional biopsies for right breast ductal carcinoma in situ. A 6 × 10 cm piece of AlloMax was placed on the medial aspect of each breast between the implant and the skin flap. Follow-up was performed at 1 week, 3 months, and 1 year following the procedure. The patient recovered well from the surgery and there were no complications. At her first postoperative follow-up the patient was extremely satisfied with the result. At her 3-month and 1-year follow-up she had no recurrence of her previous deformity and no new deformity.

Highlights

Prosthetic implant use for cosmetic breast augmentation and postmastectomy breast reconstruction is a common procedure
A review of the current literature includes many references to the use of AlloDerm (Life-Cell Corporation, Branchburg, NJ), the first commercially available acellular dermal matrix (ADM) product, to repair breast rippling associated with prosthetic implants [5,6,7] but there is currently no literature on the use of AlloMax (Bard-Davol, Warwick, RI) for the same indication
AlloMax is a similar ADM product; in contrast to AlloDerm, AlloMax is terminally sterilized using Tutoplast process, which is a proprietary process for decellularization, sterilization, and viral inactivation

Summary

Introduction

Prosthetic implant use for cosmetic breast augmentation and postmastectomy breast reconstruction is a common procedure. Rippling is the appearance of vertical folds on the skin of a patient with a prosthetic breast implant and is most visible when the patient is in an upright and/or forwardleaning position. It is noted in about 0–10% of patients after prosthetic breast implant augmentation/reconstruction [3,4,5] and 5–50% of cases require reoperation [4].

Case Report

Discussion

Findings

Conclusion