Implant Breast Reconstruction using AlloDerm Sling; Clinical Outcomes and Effect to Capsular Formation

ABSTRACT

PURPOSE: Breast surgeons usually insert tissue expander or implant beneath the subpectoral-subcutaneous dual plane in breast reconstruction. But sometimes it happens unsatisfactory lower pole fullness, asymmetric inframammary fold and breast shape. To solve all the problem like these, we introduce implant breast reconstruction using AlloDerm sling. METHODS: The AlloDerm sling was used in 13 patients and 18 breasts for implant breast reconstruction. After mastectomy, costal and lower sternal insertion of pectoralis major muscle was detached. Rehydrated AlloDerm was sutured to the chest wall and serratus anterior fascia at the level of inframammary fold downward and to lower border of the pectoralis major muscle upward like crescent shape with tension free technique after implant insertion into the subpectoral-subAlloDerm dual pocket. And we evaluate subpectoral capsule and subAlloDerm capsule histologically for the capsular thickness, amount of myofibroblast and TGF-beta expression. RESULTS: We make satisfactory lower pole fullness, symmetric inframammary fold and breast shape using AlloDerm sling. SubAlloDerm capsule was thin than subpectoral capsule. SubAlloDerm capsule have fewer myofibroblast and lower TGF-beta expression than subpectoral capsule. CONCLUSION: Implant breast reconstruction using AlloDerm sling makes easy to get natural breast shape through satisfactory lower pole fullness, symmetric inframammary fold and implant positioning.