Implant surgery is the most straightforward way of creating a new breast after mastectomy, without taking tissue from elsewhere on the body. Either a saline filled (expander) or a silicone implant is inserted under the muscle and skin to replace the breast that has been removed at the time of mastectomy. This is a relatively simple operation and can be performed at the same time as mastectomy (immediate) or at a later date (delayed). It does not produce the most natural looking or feeling breasts. This procedure may be suitable if both breasts (bilateral) are to be reconstructed or if other procedures are not deemed appropriate.
ADM is a natural tissue that has had its cells removed to leave behind collagen and extracellular matrix components. ADM is like a scaffold network that provides support and acts as a framework for the patient’s tissues to grow into. Thin sheets of ADM were initially developed for use in burn patients as a template for skin replacement. Their use was then extended to a more structural function as a natural repair layer in the abdominal wall rather than synthetic mesh. More recently ADM been used in implant-based breast reconstruction and augmentation procedures.
Decellularisation is required for all ADMs. Cells must be removed to prevent an immune reaction or rejection by the patient receiving the product. The detergents used to achieve this differ by product. Dehydration is the next step, making the tissue easier to handle, improving shelf life and reducing loss of some intrinsic growth factors. ADMs can be dehydrated either through freeze-drying or by vacuum pressing. There is no clear evidence in the literature that one type of sterilisation is better than any other although if a preservative is used, it should be thoroughly washed away at the time of surgery to prevent a reaction.
Once the ADM has been placed inside the body, you will incorporate the new tissue framework as if it belonged to you with rapid new blood vessel and tissue growth. There are no known long term problems associated with ADM use once it becomes fully incorporated.
| Surgery duration | 3 hours |
| Type of anaesthesia | general anaesthetic |
| Compression/support garment | yes |
| Time in hospital | 1 night |
| Time off work | 2 weeks |
| Recovery time | 4-6 weeks |
| First follow up appoinment | 1 week |
ADM is a natural tissue that has had its cells removed to leave behind collagen and extracellular matrix components. ADM is like a scaffold network that provides support and acts as a framework for the patient’s tissues to grow into. Thin sheets of ADM were initially developed for use in burn patients as a template for skin replacement. Their use was then extended to a more structural function as a natural repair layer in the abdominal wall rather than synthetic mesh. More recently ADM been used in implant-based breast reconstruction and augmentation procedures.
Decellularisation is required for all ADMs. Cells must be removed to prevent an immune reaction or rejection by the patient receiving the product. The detergents used to achieve this differ by product. Dehydration is the next step, making the tissue easier to handle, improving shelf life and reducing loss of some intrinsic growth factors. ADMs can be dehydrated either through freeze-drying or by vacuum pressing. There is no clear evidence in the literature that one type of sterilisation is better than any other although if a preservative is used, it should be thoroughly washed away at the time of surgery to prevent a reaction.
Once the ADM has been placed inside the body, you will incorporate the new tissue framework as if it belonged to you with rapid new blood vessel and tissue growth. There are no known long term problems associated with ADM use once it becomes fully incorporated.
Surgery duration : 3 hours
Type of anaesthesia : general anaesthetic
Compression/support garment : yes
Time in hospital : 1 night
Time off work : 2 weeks
Recovery time : 4-6 weeks
First follow up appointment : 1 week
Once you have decided you are interested in cosmetic surgery
Mr Saour’s aim is to help you look and feel your best through high quality personalised care.
You will receive all the information preoperatively allowing you to make an informed decision.
Understanding the benefits, implications and potential risks of any type of surgery is of paramount importance.
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