Cancer

Alloderm is immediately beingness used routinely inwards pectus reconstruction. Here's what you lot necessitate to know...

First off, what is it? AlloDerm is derived from donated (cadaveric) human skin. It is FDA approved too is used inwards many dissimilar types of reconstructive surgical operation including pectus reconstruction. Before beingness packaged for use, the Alloderm undergoes a multi-step procedure that removes all the cells that tin range the sack Pb to tissue rejection: fifty-fifty though it comes from approximately other person, your trunk does non decline Alloderm because the immune cells are removed. Alloderm essentially acts every bit a scaffold too over time, the patient's ain cells grow into it.

Since it is a human (cadaveric) product, the U.S. Tissue Bank rigorously screens all tissue donors' medical records. All donors must live negative for Syphilis, Hepatitis B too C, too HIV 1 too 2. AlloDerm grafts are too examined nether the microscope earlier too afterward processing to dominion out contamination.

Alloderm is oft used inwards implant-based pectus reconstruction (and has been for years). The tissue expander or implant is placed nether the pectoralis (chest) muscle. The to a greater extent than tissue coverage over the implant, the ameliorate the results. Unfortunately, the pec musculus cannot comprehend the entire implant. The Alloderm is used to comprehend the lower travel of the implant that is non covered past times muscle.

Advantages:
- Stabilizes the implant inwards position.
- Allows for consummate implant coverage.
- Can permit the creation of a full-sized pectus when the tissue expander/implant reconstruction is performed at the same fourth dimension every bit the mastectomy.
- No run a endangerment of rejection.
- Once incorporated past times the body, resists infection every bit good every bit the patient's "natural" tissue.

Disadvantages:
- Like anything that is implanted inwards the body, at that topographic point is an initial (low) run a endangerment of infection (until it becomes incorporated).
- Can drive temporary redness inwards the peel over the Alloderm.
- Costly but unremarkably covered past times insurance.

Many plastic surgeons, including myself, utilization Alloderm routinely when performing pectus reconstruction amongst tissue expanders too implants.

Dr C

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Implant pectus reconstruction is the most mutual method of pectus reconstruction currently performed inwards the US. There are 2 principal approaches: the "Alloderm one-step" (also referred to equally "single stage" or "direct to implant" reconstruction), as well as the two-stage reconstruction alongside tissue expanders. To easier explicate the ins-and-outs of the one-step procedure, I start ask to summarize the to a greater extent than traditional two-stage approach...

Tissue expanders essentially human activity equally "spacers". They tin either live placed at the same fourth dimension equally the mastectomy or some fourth dimension later. They are inflated alongside saline injections to recreate the desired pectus size. This expansion physical care for tin lead maintain several weeks depending on the amount of expansion required to accomplish the optimal loving cup size. Once the expansion physical care for is completed, the tissue expanders are removed as well as the concluding implants are placed. Reconstruction alongside pectus implants is thence unremarkably performed equally a multiple-step physical care for as well as tin lead maintain several months.

Alloderm One-Step / Single Stage / Direct to Implant Reconstruction

Some patients are candidates for a "One-Step" physical care for whereby the permanent implant is inserted at the fourth dimension of the mastectomy. Influenza A virus subtype H5N1 cadaveric implant known equally Alloderm is besides used to supply extra implant coverage as well as support. By going straight to the concluding implant inwards a unmarried stage, the patient has solely i physical care for as well as avoids the purpose of a tissue expander (and the whole expansion process) altogether. The scar tin besides live placed inwards the inframammary bend (at the pectus crease) which makes it much easier to hide. The One-Step physical care for is besides referred to equally "direct to implant" or "single stage" reconstruction.

This physical care for is apparently really appealing to many women, including those that may non live candidates for perforator flaps. The downwards fourth dimension inwards damage of recovery is besides much shorter than most of the alternatives (2-4 weeks).

There are some caveats though.... I used to offering this physical care for to most patients. Some One-Step surgeons even then do. Personally, I don't anymore - "the perfect candidate" for the physical care for has evolved inwards my eyes. Experience (and grayness hair) has a vogue of doing that.

So who is the "ideal candidate"?

1) Patients that practise non lead maintain a electrical flow pectus cancer diagnosis

2) Patients that are having rubber mastectomy only, e.g. for BRCA1 or BRCA2

3) Patients that are having nipple-sparing mastectomy

4) Patients that practise non ask a pregnant pectus lift

5) Patients that lead maintain non had previous breast/chest radiation


By limiting the physical care for to women who fulfill these strict criteria the surgical results are far to a greater extent than predictable as well as really cosmetic. The opportunity of farther revision or "touch up" procedures is besides really low.

PRMA patient Mrs Michelle Coben kindly shares her sense alongside the One-Step physical care for inwards the video below. You tin besides consider before as well as after pictures here.



I promise this information helps.

Dr C



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