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Use of porcine acellular dermal matrix in aesthetic breast surgery
Shayda Mirhaidari, MD, Gregory M. Beddell, MD, Jennifer A. Haas, MD, Douglas S. Wagner, MD
Summa Health System
2014-03-14
Presenter: Shayda Mirhaidari
Affidavit:
The above residents completed the majority of this original work
Director Name: Douglas S. Wagner
Author Category: Other Specialty Resident
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)
Background: Aesthetic breast surgery accounted for 460,000 procedures in 2012. Many of these procedures are met with complications; capsular contracture and implant malposition. Contracture is one of the more devastating complications occurring in 9.8-14.8% of patients. Strattice (Lifecell Corporation, Branchburg, NJ), a porcine acellular dermal matrix, has played a pivotal role in providing additional tissue support and complication reduction.
Methods: A 5-year retrospective review of a single surgeons experience was performed. Fifty-seven consecutive patients had Strattice placed in 101 breasts. We reviewed risk factors, indications, complications, and surgical failures.
Results: Seventy-eight breasts had capsulectomy and Strattice placement for capsular contracture with a complication rate of 3.9% and recurrence rate of 2.6%. We identified two hematomas requiring drainage, one seroma requiring drainage, and zero infections. An additional 12 breasts had a partial capsulectomy, capsulotomy, or capsulorrhaphy and Strattice placement for malposition or rippling. In this group, no complications were identified and 8.3% (1/12) had a treatment failure. The remaining 11 breasts had primary placement of Strattice. Five breasts received Strattice for contracture prevention, in which there was a 0% complication rate. Four breasts had Strattice placement for IMF positioning, with one breast requiring a return to the operating room for recurrent malpositioning. Two breasts had a Strattice doughnut placed for nipple-areolar complex (NAC) control. One of the breasts required additional NAC revision. Mean follow-up was 21.2 months.
Conclusions: Strattice use in revisional breast surgery has a high success rate and a low complication rate.
