The use of human acellular dermal matrix for the correction of secondary deformities after breast augmentation: results and costs.

[BACKGROUND] Secondary breast deformities following breast augmentation constitute some of the most challenging and difficult problems to correct. Although the application and efficacy of human acellular dermal matrix in breast reconstruction has been previously reported, there is little information in the literature relating to its indications, results, or cost in aesthetic breast surgery.

[METHODS] This study retrospectively reviewed a single surgeon's experience in correcting secondary deformities with human acellular dermal matrix after breast augmentation from 2005 to 2009. A total of 23 patients (38 breasts) were included in the study.

[RESULTS] There were 28 breasts with surface irregularities and 22 breasts with implant malposition (12 had both). On average, 1.13 sheets of human acellular dermal matrix were used per breast per operation. At the authors' institution, this material equates to a cost to the patient of $3536 to $4856 per breast (depending on sheet size and thickness). Twenty of 23 patients (87 percent) [32 of 38 breasts (84 percent)] had improvement in their breast deformity after breast revision surgery. Three patients (six breasts) needed another cosmetic breast operation before the end of the follow-up period: two because of persistent surface irregularities and one with a request for larger implants. One patient (3 percent) had an infection in one breast, requiring removal of the human acellular dermal matrix.

[CONCLUSIONS] Human acellular dermal matrix is a useful and safe adjunct for correction of contour deformities after breast augmentation. Its high cost, however, may be a deterrent to widespread use in self-pay patients.