What Is the Role of the Acellular Dermal Matrix in Breast Reconstruction?

February 8th, 2017

breast reconstruction northern virginiaWhen I conduct breast reconstruction procedures for Fairfax-area patients, those in my care can choose from a variety of surgical options based on their needs and goals. If you are receiving breast reconstruction with an implant, you will benefit from the acellular dermal matrix.

The breast naturally has ligaments that attach to your chest wall and suspend its weight. However, implants don’t have this sort of system for suspension. After a mastectomy, inserting the implant into the skin without suspension would cause rapid stretching.

Before the introduction of the acellular dermal matrix about 20 years ago, breast reconstruction patients received tissue expanders.

Support and Structure for Your Breast

The surgeon would create a pocket beneath the muscles of the chest wall, insert the expander, and over time, increase the size of this pocket until it was large enough to accommodate an implant. However, this approach has a few disadvantages: it moves the muscles out of their natural position, it’s uncomfortable, and it’s slow. Many of the Fairfax-area breast reconstruction patients I see are good candidates for the acellular dermal matrix instead.

This material is used to construct an “internal bra” by holding the implant in place to provide a more natural-looking, attractive, and comfortable result.

The acellular dermal matrix is a well-established approach that offers significant advantages over earlier techniques. It is scaffolding that is completely internal to the breast and is made up of natural tissue cells. If we determine that you are a good candidate for using an acellular dermal matrix, I will apply the technique in your procedure.

How the Acellular Dermal Matrix Works in an Implant Breast Reconstruction

During the mastectomy and reconstructive surgery, I size the implant’s height, width, volume, and projection to suit your needs. As part of this process, I use sizer implants, which are disposable, to “try on” and to determine which option will give you the best result.

Once I select the implant, I create a pocket with the acellular dermal matrix to the chest wall and insert the implant. By positioning this scaffolding around the implant, I can prevent it from shifting out of place.

This approach has a variety of benefits:

  • Because the matrix comes from natural tissue cells, your own blood vessels and cells will eventually absorb it as part of your body.
  • Northern Virginia / Fairfax breast reconstruction patients receiving an implant can have their reconstruction immediately following their mastectomy. There is no waiting until the tissue has expanded enough to accommodate an implant.
  • You don’t need to go through the discomfort that a submuscular tissue expander causes.

Regardless of these advantages, you may still benefit from the use of a tissue expander instead of an acellular dermal matrix if:

  • You do not have enough skin to cover the implant.
  • Your skin after a mastectomy isn’t healthy enough.
  • You are having a nipple sparing mastectomy.

In these cases, the tissue expander may offer significant advantages. We will discuss these details and more during your consultation.

Learn more about the different options available to you with breast reconstruction. Fairfax-area patients can schedule an appointment with Dr. Jespersen by calling (703) 992-7969 or completing our contact form.

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