The Use of Porcine Acellular Dermal Matrix In Revision Cosmetic Breast Augmentation

Goals/Purpose: Aesthetic breast augmentation surgery can be fraught with postoperative complications, particularly regarding capsular contracture, skin surface irregularities, and implant or inframammary fold malposition.  Correction of these deformities is often difficult and recurrences are common.  Similar challenges have been addressed successfully in reconstructive breast surgery with the use of acellular dermal matrix products.  Herein we present our initial experience with acellular porcine dermal matrix to solve challenging aesthetic breast augmentation problems.

Methods/Technique: Retrospective chart review of 41 patients who received revision cosmetic breast augmentation on 67 breasts, with or without mastopexy, with the use of porcine acellular dermal matrix (PADM) (Strattice, Lifecell Corporation, Branchburg, NJ) from May 2009 to December 2010.  39 of 41 patients were operated upon by one surgeon (JNP) and 2 were operated upon by another (OMR).  The data was analyzed for product use description and complications including infection, extrusion, capsular contracture, and implant malposition.

Results/Complications: 67 revision cosmetic breast augmentation surgeries were conducted with the use of PADM.  There was a total of one complication (1.5%), which was an infection in one breast that required implant explantation approximately 2 weeks post initial procedure.  Two patients required office procedures under local anesthesia to correct minor imperfections.  There were no capsular contracture recurrences in the eight patients who underwent capsulectomy and Strattice placement.  

Conclusion: PADM proved to be a useful adjunct in revisionary breast augmentation surgery.  This helped to provide good aesthetic outcomes with low complication rates.  Prospective, randomized trials may be helpful to define the role of PADM further in these challenging cases.