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.