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Direct-to-Implant
("One-Step") Reconstruction
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| Using acellular dermis creates an instant pocket, eliminating the need for expansion |
If
you've decided on implant reconstruction, you may want to consider direct-to-implant or one-step reconstruction. Some
doctors are now using an acellular dermal matrix, such as AlloDerm®, DermaMatrix®,
or Tutoplast®--donated human tissue from which the cells have been removed--or Strattice™ (derived from porcine dermis) to facilitate this streamlined reconstructive
process.
Typically, the chest muscle and
breast skin must be expanded over a period of several weeks to create a pocket of sufficient size to hold the implant. Alternatively,
stitching patches of acellular dermal matrix to the sides of the muscle or along the inframammary fold creates an instant
pocket and more complete coverage of exposed implant edges.
Direct-to-implant reconstruction offers three distinct
benefits over traditional implant reconstruction:
- It
doesn't require expansion.
- Women who combine this procedure
with skin-sparing, nipple-sparing mastectomy can complete their entire reconstruction in a single step.
- Acellular dermal matrix integrates into a woman's healthy tissue.
Two things you should know about this procedure: although the number
of plastic surgeons who offer this type of reconstruction is growing, most still rely on traditional implant reconstruction
with expansion. Also, in some cases, women do need a secondary procedure to correct problems or improve cosmetic result.
Although breast reconstruction with AlloDerm or DermaMatrix is not yet widely performed, acellular dermis has been
used for years in other types of reconstructive surgeries (it's commonly used to repair abdominal wall tears that can
occur after TRAM reconstruction), and to replace missing or damaged skin and cover wounds. Like other reconstruction methods,
it makes good sense to research a direct-to-implant reconstruction procedure and your surgeon's expertise before
making a decision.
When consulting with a surgeon who reconstructs with AlloDerm or DermaMatrix, be sure to clarify whether he/she performs single-step direct-to-implant or traditional reconstruction with
expansion.
Note: Although most surgeons prefer to place an immediate implant
under the muscle, some position the implant above the muscle (between the muscle and breast skin).
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Surgeons who Perform One-Step
Implant Reconstruction
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Phoenix
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Scottsdale
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Los Angeles
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Dr. Mark Mofid
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Dr. Michael Newman
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Dr. Hilton Becker
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Missouri
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New Jersey
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Dr. Michael Gimbel
Dr. James O'Toole
412-687-2100
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Dr. Kevin Delaney
Dr. Marga Massey
Dr. Dennis Schimpf
843-792-4700
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Dr. Patrick O'Neill
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Dr. Kevin Delaney
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Houston, St. Luke's
Houston, The Woodlands
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Dr. Marga Massey
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Updated January 2012
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Note:
The information on this site is provided for educational purposes only and should not be interpreted as medical advice. © 2003-2012 Carlo Press Publications
PO Box 7019
San Carlos,
CA 94070
info@breastrecon.com
info@breastrecon.com
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