Friday, December 11, 2009

Alloderm with the use of implants - is it safe?

The following is an excerpt from questions submitted by the Young Survival Coalition. I have been asked to answer questions on breast reconstruction as an expert.

How safe is the use of cadaver tissue (Alloderm) in breast reconstruction with implants?

Alloderm is one brand name product of human cadaver (donated by dead people) dermis, which is the bottom strength layer of skin. It is sometimes used in reconstructive surgery to potentially add another layer of tissue to thicken the mastectomy skin, to help hold submuscular implants in place, or to decrease rippling of implants.

Alloderm is a "graft", which by definition does not have a blood supply. This is in contrast to a "flap", which has a blood supply and may be either attached to a muscle ("pedicled"), or "free", which involves microsurgery to disconnect and then reconnect tiny blood vessels under the microscope.

If the breast skin has been radiated already, the use of Alloderm adds the additional risks of infection, wound healing problems, and/or the need for implant or Alloderm removal. This is because the radiation interferes with blood vessels growing into the product, and slows the rate of incorporation of the product.

I unfortunately have removed much more Alloderm (inserted by other surgeons) in my patients that I have ever put in myself. I personally do not use this product, but understand that many surgeons do.