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Is ADM a Good Option for Implant Revision Patients?

breast aug with liftBreast implant surgery is one of the most common cosmetic surgery procedures performed in the U.S. today, and as a result of the wealth of experience that has developed surrounding it, it’s also one of the most successful. While some patients may achieve a successful resolution through traditional revision surgery, others can benefit substantially from the incorporation of acellularized dermal matrix (ADM) as part of their procedure. (You can read more about ADM in a recent blog post here.) ADM has been used for years in post-mastectomy reconstructive breast surgery patients to help heal tissue damage and strengthen and stabilize weak or thinned tissues. Based on the excellent results achieved in those patients, cosmetic surgeons have recently begun using the meshlike material in implant revision surgery to achieve more aesthetically pleasing, longer-lasting results in patients experiencing post-implant issues including:

Bottoming Out

Patients who have thin or stretched skin may experience a loss of the skin’s natural elasticity, resulting in skin that is extremely loose or lax. These patients are susceptible to bottoming out, a condition that occurs when the envelope supporting the breast implant drops, causing a sagging, pendulous appearance. In these patients, the nipple ends up siting high on the breast with the bulk of the breast tissue hanging well below the nipple. The breast skin may also appear stretched below the nipple, magnifying the breast’s droopy appearance. In these patients, ADM can be used to provide a supportive meshwork between the breast tissue and the chest muscle, keeping the breasts in a more desirable position.

Capsular Contracture

Contracture occurs when unnaturally thick scar tissue forms around the implant, squeezing the implant over time and causing tightness and other changes in the appearance of the breast as well as discomfort in many patients. ADM has been shown to help thwart the formation of unnaturally thick scar tissue that causes contracture. Although it’s not entirely clear how it “shorts out” the scarring process, some experts believe ADM may help reduce inflammation that causes scarring; by promoting the rapid growth of healthy cells, ADM also may help “crowd out” scar tissue cells, preventing the formation of thick, fibrous tissue.

Rippling/Wrinkling

Wrinkling and rippling typically occur when the pocket formed to surround the implant stretches, becoming too large for the implant and allowing it to move or migrate from the desired position. The laxity that occurs can cause the tissues surrounding the breast to become loose, eventually resulting in wrinkles Wrinkling also can occur in women whose breast tissue is weak or thin. ADM is used to provide a supportive sling for the implants; over time, the patient’s own cells will form within the matrix, increasing support.

Fold Malposition

The natural folds along the bottom and side of the breasts are an integral part of the body’s natural curves. In some patients, especially those with thin or weak breast tissue, the pockets supporting the implants can become compromised, allowing the implant to drift downward or sideways, causing folds to flatten out and resulting in an unnatural appearance. ADM acts as a “tissue buttress,” providing added support for the pocket and redefining the natural folds.

The need for revision surgery is most common among women with thin or weak breast tissue, but complications can occur in any patient, especially as they age. Added to a revision procedure, ADM can help patients achieve their aesthetic goals and increase their self-confidence and self-esteem. Give us a call today to learn more (305) 861-6881. You can also read more about the breast procedures that Dr. Krau performs on these pages: Miami Breast Lift, Breast Augmentation, Breast Revision.

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Miami Plastic Surgery Center
Ary Krau, M.D.

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Bay Harbor Islands, FL 33154

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