Use of “acellular dermal matrix” (ADM) is now helping improve outcomes following breast reconstruction revision surgery, new research suggests.

Scott L. Spear, MD, and colleagues at Georgetown University Hospital in Washington, DC, report good results with techniques using ADM for revision breast reconstruction. “ADM has proven to be a reliable tool in managing some of the most common and challenging problems in implant-based breast reconstruction, ” Spear and colleagues conclude. The findings appear the January issue of Plastic and Reconstructive Surgery.

During a 5-year period, Spear and colleagues used ADM as part of revision surgery for cosmetic improvements and other problems in a total of 135 breast reconstruction procedures. The most common uses were to address problems affecting the appearance of the lower breast: either to correct the inframammary fold, or to provide support in 26% for the lower pole of the breast. In 27% of cases, ADM was used to manage capsular contracture. Less commonly, ADM was used to manage problems related to “rippling” or symmastia.

The overall success rate was 95.5%, with a complication rate of just 5%. Further surgery was needed in only about 1% of cases—a much lower rate than in premarket studies of ADM for repeat breast augmentation surgery. Although there were complications, there was a high frequency of success in managing these challenging problems.

“Increased patient expectations have blurred the line between reconstructive and aesthetic breast surgery, challenging surgeons to find innovative and reproducible ways to create favorable, reproducible, and durable results, similar more and more to the results obtainable with cosmetic breast surgery,” the study authors write.