Esthetic Outcomes of ADM-Assisted Expander-Implant Breast Reconstruction

Objective: Adjunct acellular dermal matrices (ADM) are thought to improve esthetic outcomes of breast reconstruction but the existing evidence is largely anecdotal. In this study, we provide comparative data on esthetic outcomes of expander-implant breast reconstruction with and without ADM. Methods: Chart review was performed on a consecutive series of expander-implant reconstructions by the senior author. Demographic, oncologic, surgical, and photographic data were obtained for each patient. Photographic data were scored using a 3-point (0-1-2) breast-specific esthetic scale by 3 blinded, independent reviewers not involved in patient care. Results: ADM-assisted breast reconstructions had significantly higher scores than the non-ADM reconstructions for breast mound volume (1.38 vs 1.11; P = .0102), breast mound placement (1.57 vs 1.39; P = .0217), and the inframammary fold (1.39 vs 1.23; P = .0458). Conclusions: ADM may improve breast volume, placement, and inframammary fold definition. These specific findings may help plastic surgeons better utilize ADM to improve outcomes for breast reconstruction.