Goals/Purpose: Although acellular dermal matrix (ADM) materials have been in use for over a decade in primary and secondary breast reconstruction, and some cosmetic breast surgery, little has been published on the outcomes of these materials for cosmetic applications. The purpose of this study was to identify the indications and outcomes for use of a specific porcine derived acellular dermal matrix (Stratticeª) in primary and revision cosmetic breast surgery.
Methods/Technique: A retrospective, IRB-approved review was performed of all patients who had Stratticeª used for cosmetic breast surgery by the senior author. Patient demographics, indications, surgical findings, and postoperative course were collected and data analyzed using descriptive statistical tools.
Results/Complications: Between 2008 and 2012, Stratticeª was used in 43 cosmetic breast surgeries (75 breasts) by the senior author. 69 of the 75 breasts (92%) were revision surgeries. Indications included inferior pole support (39 breasts, 52%), fold malpositions (28 breasts, 37%), capsular contracture (25 breasts, 33%), and rippling/palpability (6 breasts, 8%). Three patients (six breasts) had Stratticeª placed during primary augmentation/mastopexy. At the time of final follow up, 74 of the 75 breasts (98.7%) had successfully achieved the indication for which the Stratticeª was placed; one breast (1.2%) had some degree of relapse. The global complication rate for all patients in this study is 5.3%--two breasts (2.7%) had postoperative fold malposition, one breast (1.2%) had bottoming out, and one breast (1.2%) developed an infection that resulted in temporary device explantation.
Conclusion: The use of Stratticeª is safe and may be helpful in the management of certain situations in cosmetic breast surgery, including needed lower pole support, capsular contracture, rippling, and implant malposition.
Figure 1A
Figure 1B
Figure 1C
Figure 1D
Figure 1E
Figure 1F
Figure 1: A 43 year old female patient presented with recurrent bottoming out and IMF malposition following previous breast augmentation/mastopexy surgeries (A,B). The surgical strategy was to perform another augmentation/mastopexy using smaller implants (Allergan 68MP-240 saline smooth round implants filled to 270 cc were exchanged with Allergan style 15, 213 cc silicone smooth round implants), with capsulorrhaphy to elevate the lower IMF and placement of Stratticeª to buttress the inferior pole (and support the new IMF) (C). Stratticeª was applied along the inferior pole, sutured superiorly to the pectoralis major muscle and inferiorly to the new IMF, to cover the inferior pole of the implant (D). Postoperative results are shown after 7 months (E, F).