A LITTLE KNOWLEDGE CAN BE A DANGEROUS THING!
The worst thing a patient can do is to go on the internet and think they have become an expert on a medical topic. Notice I specified medical, since it is possible to gain vast amount of knowledge on a topic which is more predictable than medicine.
Recently, my office manager asked me if I can answer a question a prospective patient has over the phone. This person sounded young, most likely in her twenties, and as soon as I answered the phone she said “I was referred to you by a patient of yours, so Stratis prevents (breast) capsular contracture, right?” It took me a few seconds to try to process what she had asked. She most likely is referring to the use of either dermal allograft (using the dermal portion of the skin obtained from humans-the most common one being Alloderm) or using a xenograft (use of animal dermis or collagen framework) in conjunction with breast implant. I tried to educate her as best as I could, but she was so arrogant and set on her ways with the use of such products, I decided to tell her I do not have the skills to achieve what she desires.
The routine use of Alloderm or similar products has been mainly for breast reconstruction. The graft is sutured inside the skin which has contact with the implant. The alloderm provides thickness and protection for the implant. Over the past few years, cosmetic use of these products has been for revision breast augmentation (the implant being too low or the implants touching each other in the midline-symmastia). The graft acts as a sling for low riding implants or as a spacer for symmastia cases.
However, at this time, the routine use of such products for aesthetic breast surgery is not recommended. If a patient has extremely thin skin, the use of product can provide thickness to the skin and minimize chance of implant rippling and palpability. However, the main obstacle to use of such grafts is the cost. Depending on the size of the graft needed, the average cost is around $2000. This is in addition to the cost of breast augmentation.
Furthermore, there is no data to show that use of such products can prevent capsular contracture. Even with the vast experience we have with the use of breast implants, there is no solution for prevention of capsular contracture. Certainly bleeding after surgery, lack of patient compliance (patient does not massage the implants or wears push-up bras within the first month of surgery), infection, or use of non-textured implants above the pectoralis muscle (subglandular position) have been shown to increase the risk of capsular contracture. However, currently we have no way of preventing this complication.
This is the danger of “Googling” things, especially of a medical nature. There is a lot of mis-information and non-authorative comments by the public which can “disorient” a potential patient. In general, when a surgical procedure is requested, there is NEVER 100% guarantee. A good surgeon can minimize complications and breast revision surgery to very low percentage, but never to zero.
So please, read non-medical information with a grain of salt. Authorative information regarding plastic surgery can be obtained through the American Society of Plastic Surgeons, www.plasticsurgery.org, or similar web-sites.
Michael A. Jazayeri, M.D. is a board certified plastic surgeon in Santa Ana with over 13 years of experience. His office is located in Orange County, California. To schedule a complimentary consultation, please call (714) 834-0101.