Strattice™ and Alloderm®

Dr. Teitelbaum was a long term consultant to the company that manufactures Alloderm® and Strattice™, the most widely tested and most published acellular dermal matrix (ADM’s) available to patients.
 
Along with a few others, Dr. Teitelbaum was a key figure in developing the methods of using these products in revisionary breast surgery.   He has since been a principle teacher and has instructed hundreds of plastic surgeons in how to approach these cases.  He has instructed at cadaver labs to demonstrate technique nuances and perform the operation for other surgeons.  An important instruction guide for the use of these products as well as a key article on the use of ADM for breast revision in the most important plastic surgery scientific journal was authored by Dr. Teitelbaum.

His opinions on management of these cases has been sought after by many plastic surgeons around the country, and his email inbox often contains advice requests from surgeons on the applicability of ADM for patients in their practice.  He has been referred many difficult cases requiring ADM by colleagues in Southern California.  Manufacturers have asked his advice in developing future products and in devising the operations to use them.

Weak or inadequate tissue is the most vexing problem in breast revision surgery.  If the tissue is thick, there is almost no problem that cannot be fixed.  On the other hand, nearly all of the unsatisfactory outcomes in revision breast augmentation are a result of thin, weak, or damaged tissue.  Thus, efforts to thicken and strengthen the tissue are very important.

Some plastic surgeons with extensive ADM experience have anecdotally noted a very low incidence of capsular contracture in patients who received these products. Dr. Teitelbaum has been offering Strattice™ and Alloderm® to patients with recurrent

Strattice™ is derived from the skin of specially raised pigs, and Alloderm® comes from human cadavers.  Some women are uncomfortable with these sources and decline using them despite any benefits they may offer for them.  Others feel compelled to do whatever they need to improve their problem.  And others are comfortable knowing  that hundreds of thousands of women received cow derived collagen injections into their lips and that millions more received pig insulin for treatment of their diabetes.

Another issue for many patients is that these products can add thousands of dollars to the cost of a revision breast surgery.   However ADM remains the only solution for some of the most difficult, frustrating, deforming, and embarrassing problems after breast augmentation surgery.

Dr. Teitelbaum has many patients whose process of operation after operation with dissatisfying results were finally fixed with the proper and careful use of ADM.  At a consultation his patients receive a thorough analysis of their situation and an understanding of the applicability of these products for them.

Before and After Strattice and Alloderm Photos

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  1. Capsular Contracture (Left), Lateral Malposition (R)

    The right implant is low and outside. Strattice was used to strenghten the weak tissues in that area and move the impalnt inwards. The left had recurrent contractures, and Strattice was used to reduce the chance it would happen again.

  2. Capsular Contracture, Drooping, Wants Larger Implants

    The scar tissue made her implants high, hard, and round. Scar tissue was removed and Strattice used to reduce chances of contracture. Larger implants were placed. Her tissue is droopy, but she did not want a lift.

  3. Rippling

    Her implants were supposed to have been behind the muscle, but the muscle was so damaged that there was none left to put the implant behind. Strattice was used to add coverage and keep what little muscle there was over the implants.

  4. Capsular Contracture, Nipple Distortion

    She has had multiple occurences of capsular contracture, so Strattice was used to prevent it from recurring. It was also used to fix the defect on her areola. This is a very disfiguring complication of that incision.

  5. Replacement after Removal

    This patient had capsular contracture so many times she decided to have her implants removed. But she wanted them back. So they were replaced with Strattice, which evidence shows can reduce the chance of it recurring. She has stayed soft ever since.

  6. Rippling, Strattice

    Rippling is always worst when someone bends over. Note from her breastbone how thin she is (rippling is a problem of thinner patients.) Thickening the area with Strattice cured her rippling problem.

  7. Medial/Inferior Malposition - Symmastia

    Concave breast bone and large implants caused symmastia. Strattice was used to reduce and strengthen new pockets, and smaller implants were placed. The left implant was also too low.

  8. Severe Rippling

    This patient had such large implants they thinned her tissue. And her muscle was damaged, so she lost coverage over the implants. Note the implant fold at 7 O'Clock on the right breast. Strattice was used to thicken the tissue and pull the muscle down.

  9. Capsular Contracture, Strattice

    Her left breast was always soft and pretty, but the right kept geting hard after multiple surgeries. The scar tissue was removed and Strattice was placed. The breast has remained soft.

  10. Symmastia, Wants Smaller

    It is obvious that her implants were simply too wide for her chest. They could not go anywhere but touch in the center. The central pocket was closed, reinforced with Strattice, and smaller implants were placed.

  11. Contracture, Rippling, Strattice

    Her implants were supposed to be behind the muscle, but the muscle was damaged which caused the upper inner rippling. Strattice reinforced the muscle and created enough coverage to stop the rippling.

  12. Rippling

    Significant upper inner rippling is visible on the right breast along with distortion of it. Her muscle had been damaged from previous surgery. Strattice was used to regain some muscle coverage and thicken her tissues.