Alloderm

Thank you, that really does help. It never occurred to me to consider adjusting the unradiated side, but, that makes a lot of sense. It is the side that looks fake, feels fake too. I am considerably smaller than before reconstruction, which is fine. But, I really hope that I can end up with something that is not so obviously different on both sides.

I really like the surgeon I have now and I will do as you suggest and discuss all options with him. I think your suggestion of perhaps making the adjustments to the un-radiated side may really be a solution.

You are correct in assuming that the tissue expander was replaced with an implant. I was told I was simply not a candidate to use my own tissue for reconstruction. I asked if I could gain weight to do that, but, nobody seemed to think that was a good idea :) (Darn).

Thank you again for your answer. It was very helpful.

Lisa (aka Cancerfree2b)

Anyway, I will Alloderm can be used to help improve projection and shape but based on your description of the degree of asymmetry, I dont know that Alloderm will get you to where you want to be.

It sounds as though you quite like the way the irradiated side has turned out and you are unhappy wth the appearance of the non-irradiated side (left). I would consider leaving the irradiated breast alone and adjusting the left breast. The risk of complications is always higher when operating on irradiated tissue.

Since you had a tissue expander and latissimus reconstruction, I presume the expander was replaced by an implant. It certainly sounds that way considering how "projecting" the left breast is. One option would be to downsize the implant on the left side. Using a smaller implant on that side (perhaps one with a slightly lower profile) would also help decrease the "over projection" you described. Any other adjustments that are needed in terms of shaping can be performed at the same time.

It is very difficult to say which is the best way forward for you, especially without examining you or knowing the exact details of your situation. Oftentimes there is more than one way to get the best result. I really encourage you to discuss all your options with your plastic surgeon to ensure you are as comfortable as possible with the plan moving forward.

I hope that helps.

Dr C
http://www.PRMA-enhance.com

I hear this fairly often from patients that have experienced unsuccessful implant-based breast reconstructions.

The usual culprit is infection, not rejection. Infected tissue expanders or implants are very difficult to treat and unfortunately usually require removal.

In reality, the body isn't "rejecting" the expander or Alloderm. True rejection is caused by the body's immune system reacting to tissue from another body, like a transplanted organ, not a man-made object like an implant.

I hope that helps.

Dr C
http://www.PRMA-enhance.com I hear this fairly often from patients that have experienced unsuccessful implant-based breast reconstructions.

The usual culprit is infection, not rejection. Infected tissue expanders or implants are very difficult to treat and unfortunately usually require removal.

In reality, the body isn't "rejecting" the expander or Alloderm. True rejection is caused by the body's immune system reacting to tissue from another body, like a transplanted organ, not a man-made object like an implant.

I hope that helps.

Dr C
http://www.PRMA-enhance.com

AlloDerm is derived from donated (cadaveric) human skin. It is FDA approved and is used in many different types of reconstructive surgery including breast reconstruction. Before being packaged for use, the Alloderm undergoes a multi-step process that removes all the cells that can lead to tissue rejection: even though it comes from another person, your body does not reject Alloderm because the immune cells are removed. Alloderm essentially acts as a scaffold and over time, the patient's own 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 be negative for Syphilis, Hepatitis B and C, and HIV 1 and 2. AlloDerm grafts are also examined under the microscope before and after processing to rule out contamination.

Alloderm is frequently used in implant-based breast reconstruction (and has been for years). The tissue expander or implant is placed under the pectoralis (chest) muscle. The more tissue coverage over the implant, the better the results. Unfortunately, the pec muscle cannot cover the entire implant. The Alloderm is used to cover the lower part of the implant that is not covered by muscle.

Advantages:
- Stabilizes the implant in position.
- Allows for complete implant coverage.
- Can allow the creation of a full-sized breast when the tissue expander/implant reconstruction is performed at the same time as the mastectomy.
- No risk of rejection.
- Once incorporated by the body, resists infection as well as the patient's "natural" tissue.

Disadvantages:
- Like anything that is implanted in the body, there is an initial (low) risk of infection (until it becomes incorporated).
- Can cause temporary redness in the skin over the Alloderm.
- Costly but usually covered by insurance.

In answer to the last part of your question, I use Alloderm routinely when performing implant-based breast reconstruction.

I hope that helps.

Dr C
http://www.PRMA-enhance.com AlloDerm is derived from donated (cadaveric) human skin. It is FDA approved and is used in many different types of reconstructive surgery including breast reconstruction. Before being packaged for use, the Alloderm undergoes a multi-step process that removes all the cells that can lead to tissue rejection: even though it comes from another person, your body does not reject Alloderm because the immune cells are removed. Alloderm essentially acts as a scaffold and over time, the patient's own 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 be negative for Syphilis, Hepatitis B and C, and HIV 1 and 2. AlloDerm grafts are also examined under the microscope before and after processing to rule out contamination.

Alloderm is frequently used in implant-based breast reconstruction (and has been for years). The tissue expander or implant is placed under the pectoralis (chest) muscle. The more tissue coverage over the implant, the better the results. Unfortunately, the pec muscle cannot cover the entire implant. The Alloderm is used to cover the lower part of the implant that is not covered by muscle.

Advantages:
- Stabilizes the implant in position.
- Allows for complete implant coverage.
- Can allow the creation of a full-sized breast when the tissue expander/implant reconstruction is performed at the same time as the mastectomy.
- No risk of rejection.
- Once incorporated by the body, resists infection as well as the patient's "natural" tissue.

Disadvantages:
- Like anything that is implanted in the body, there is an initial (low) risk of infection (until it becomes incorporated).
- Can cause temporary redness in the skin over the Alloderm.
- Costly but usually covered by insurance.

In answer to the last part of your question, I use Alloderm routinely when performing implant-based breast reconstruction.

I hope that helps.

Dr C
http://www.PRMA-enhance.com