Part IV: Dermal Matrices in Secondary Breast Augmentation

Owing to the benefits of acellular dermal matrices in breast reconstruction surgeries, it has also been applied to various implant related changes, namely implant associated breast deformities.³¹ The use of acellular dermal matrices can be used to improve coverage and durability of implants as well as obtaining better shape of the reconstructed breast.¹⁷ In a study conducted between 2003 and 2009, Spear et al³¹ reviewed 52 patients who had acellular dermal matrix with 77 breast prostheses. The authors established indications for use of dermal matrix as being; deficiency of skin flap, treatment of malposition, rippling, capsular contracture and implant bottoming-out. 74 of 77 were deemed successful with only 3 failures; rippling in one patient, infection in the other and bottoming out in the third. In a series of 34 patients, with breast implant related problems, Duncan³²  found a 2.9% capsular contracture rate with an 85% patient satisfaction rate and an improvement in palpable rippling. To address breast implant rippling, contracture, symmastia and bottoming out using human acellular dermal matrix, Baxter³³ found stable outcomes in 80% of revisions. Over a 52 month follow up period, Salzberg⁹ reported a 0% rate of contracture. The same result was observed in studies conducted by Zienowciz and Karacaoglu¹⁴ as well as Breuing and Colwell¹³.