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Tissue Expander Acellular Dermis

Conveniently located to serve St. Louis, Missouri

Acellular dermis is skin which has been taken from a cadaver and processed to remove all of the cells of that person. The outer layer of skin is removed and the inner layer is utilized. This product is not experimental and has been used by experienced breast reconstructive plastic surgeons for years. The advantage of this product is that it allows Dr. Cabbabe to place a larger tissue expander or implant at the time of mastectomy and the incidence of capsular contracture is reduced. This means there will be fewer fillings in the office and less time to final result. It also allows Dr. Cabbabe more accurate shaping and definition of a new lower breast fold. In select patients, a full size implant can be placed with the product at the time of surgery.

If you are having or have had a mastectomy, you may be a candidate for this procedure. This procedure may be done at the time of mastectomy or at a later time. If it is done at the time of mastectomy, Dr. Cabbabe will follow the breast surgeon into the operating room and insert an inflatable temporary tissue expander under the muscles of the chest. A biologic, regenerative mesh may be used to enhance the result. A drain will be placed between the muscles of the chest and the skin. If you have already had a mastectomy, the same steps are done. You will need to stay one to two nights in the hospital.

After discharge, Dr. Cabbabe will begin to inflate the tissue expander in the office, as early as one week after surgery. The needle will not hurt because the skin of the breast will be numb from surgery. He will inflate the expander at regular office visits until the desired size is achieved and then slightly larger for the second stage surgery . After the desired size has been reached, a second stage surgery will be done. During this procedure, the temporary tissue expander is removed, the capsule, or scar tissue around the breast, is manipulated and released in order to provide optimal shape and size. A permanent saline or silicone implant is then placed. This is often done as an outpatient procedure. Fat grafting to the upper chest is often incorporated as needed to enhance the final result. A breast lift or breast reduction may be needed on the other breast in order to improve symmetry. A new nipple can be made and areolar tattooing can be done if desired.

We believe that patients, their desires, and anatomy are all unique. Dr. Cabbabe believes that the key to a successful surgery is proper planning and discussion with the patient about their goals. Therefore, Dr. Cabbabe evaluates each patient and creates a customized surgical plan for all of his patients to meet their expectations. To schedule a consultation, call us at (314) 842−5885 or complete the contact us form.

Good candidates for this surgery are women who have small to medium breasts that do not have a significant degree of droopiness. Otherwise, it can be difficult to obtain symmetry with the other breast, even with a breast lift or breast reduction. If you are having or have had both breast removed, you may be a good candidate as well.

Poor candidates for this surgery are women who have had prior radiation and mastectomy. The skin is very difficult to stretch in this condition and leads to an increased risk of skin breakdown and implant exposure, necessitating removal.

Preparing for Surgery

Dr. Cabbabe will ask that you refrain from taking any aspirin, plavix, Coumadin or any other type of blood thinner. If you are taking chemotherapy, this may need to be finished or held prior to surgery.

Recovery

You will be admitted to the hospital for one to two nights. Pain medication and antibiotics will be prescribed. There may be some numbness on the breast which improves with time. Most patients are able to shower within 24 hours. A drain will be placed in the breast and removed in the office.

Types of Reconstruction: