Acellular Dermal Matrix in Postmastectomy Breast Reconstruction

Abstract

Over the last decade the use of acellular dermal matrix (ADM) in reconstructive breast surgery has been transformative. Some authors have gone as far as to suggest that it is the single most important advancement in prosthetic breast reconstruction. ADMs are able to provide numerous solutions for the many issues related to inadequate tissue coverage and support such as capsular contracture, implant rippling, and implant malposition. The notion of a living bra is a fascinating one for both plastic surgeons and patients alike.1 This advent has mirrored the increased use of nipple and skin sparing mastectomy, BRCA testing, and superior implants where patients are achieving better outcomes than with breast conserving treatments with lumpectomy and radiation. Despite the numerous advantages associated with ADM use, controversies remain. As such this thesis will focus on the current state of the art for ADM use in post-mastectomy breast reconstruction.