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AAPS 85th Annual Meeting
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Infero-lateral Alloderm® Hammock for Implant Coverage in Breast Reconstruction
Karl H. Breuing, MD1, Stephen M. Warren, MD2.
1Brigham and Women's Hospital, Boston, MA, USA, 2NYU Medical Center, New York, NY, USA.

To cover the infero-lateral breast implant not covered by the pectoralis major muscle and to control the implant position in breast reconstruction.
We used an acellular dermal matrix patch (Alloderm, 4x16 cm, 0.78-1.79 mm thick; LifeCell Corp., NJ) to extend the infero-lateral part of the pectoralis major muscle in 67 breast reconstructions in 43 patients after skin sparing mastectomies. By tailoring the width and position of the Alloderm® inset, the degree of lower pole fullness and position of the infra-mammary fold were precisely determined. Choice of procedure was based on patient’s preference and activity level, anatomy and lack of autologous donor tissue.
67 breasts were reconstructed from April of 2003 to November 2005. F/U ranged from 6 months to 3 years with no capsular contractures observed. Complications included 2 infections treated with wound debridement and i.v. antibiotics. One implant was lost due to extrusion after having received XRT prior to reconstruction.
This technique reduces or eliminates the need for tissue expansion. It enables correction of post-reconstructive deformities such as capsular contracture or soft tissue failure after autologous reconstruction, allows for correction of certain congenital breast deformities and provides an additional option for single-stage breast reconstruction. It is safe and reproducible and is particularly useful in patients with skin sparing mastectomies.

Breast Reconstruction with infero-lateral Alloderm® Hammock
BilateralUnilateralMean F/U ± SD (months)
Immediate with Expander-Implant3418.9 ± 11.2
Immediate with Silicone Implant12619.4 ± 16.9
Delayed with Expander-Implant0414.3 ± 3.8
Revision of Expander-Implant Reconstructions (Capsulectomy) with Silicone Implant7910.8 ± 3.8
Total Number of Breasts4423

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