Journal Article

Pocket Conversion Made Easy: A Simple Technique using Alloderm to Convert Subglandular Breast Implants to the Dual-Plane Position

M. Mark Mofid and Navin K. Singh

in Aesthetic Surgery Journal

Published on behalf of American Society for Aesthetic Plastic Surgery

Volume 29, issue 1, pages 12-18
Published in print January 2009 | ISSN: 1090-820X
Published online January 2009 | e-ISSN: 1527-330X | DOI: http://dx.doi.org/10.1016/j.asj.2008.12.005
Pocket Conversion Made Easy: A Simple Technique using Alloderm to Convert Subglandular Breast Implants to the Dual-Plane Position

Show Summary Details

Preview

Background: The advantages of dual-plane, partially submuscular breast implants are well documented. Standard conversion techniques to dual-plane positioning use marionette sutures and internal capsulorrhaphy sutures from the lower edge of the pectoralis major muscle to the anterior capsule or breast fascia within the subglandular plane. These techniques are limited by high rates of postoperative implant malposition and technical limitations that make combined mastopexy procedures difficult to perform.

Objective: We describe a simple technique familiar to most plastic surgeons accustomed to placing tissue expanders for use in breast reconstruction using Alloderm (LifeCell Corp, Branchburg, NJ) as a sling beneath the pectoralis major muscle to the chest wall.

Methods: We studied 25 women who underwent breast augmentation revision from the subglandular to the dual-plane position by performing a 9-year retrospective review from 1999 to 2007 of 2 surgeons' experience. We identified 10 women for whom Alloderm, sutured from the lower edge of the pectoralis major muscle to the chest wall, was used to create a composite pectoralis–Alloderm pocket for partial submuscular transfer of implants and 15 case controls who underwent pocket conversion using standard capsulorrhaphy and marionette suture techniques.

Results: The principal outcome variable of at least 1 complication was 73.3% without Alloderm, resulting in a 40% need for revision surgery, versus 0% with Alloderm (Fisher exact test; P < .05).

Conclusions: The standard techniques available for conversion of subglandular breast implants to the dualplane position using capsulorrhaphy and marionette sutures are limited by a high complication rate for the reliable positioning into a stable dual-plane pocket during implant exchange. A commonly used technique in reconstructive breast surgery using Alloderm is shown to reliably convert subglandular implants to the dualplane position.

Journal Article.  2202 words.  Illustrated.

Full text: subscription required

How to subscribe Recommend to my Librarian

Users without a subscription are not able to see the full content. Please, subscribe or login to access all content.