It's nice to see some main stream media articles on things like breast reconstruction rather then Dr. 90210 or Nip/Tuck. This article elaborates on single stage breast reconstruction with implants. The novel concept of this is to combine a subcutaneous mastectomy (where the nipple isn't removed) with the use a product called Alloderm to help control the shape and pocket of an implant when immediate breast reconstruction is attempted.
Alloderm comes from human skin harvested from the back of organ donors. It is processed to remove markers (antigens) that would cause you body's immune system to identify it as foreign and 'reject' it. It has found utility in hernia operations, reconstructive surgery, nasal operations, and some redo cosmetic breast surgeries where there is thin tissue coverage over an implant.
The advantage of this is that it would remove the need (hopefully) for operations to exchange a tissue expander (temporary implant that stretches the skin). The downside of this is that the skin may retract unpredictably after this type of mastectomy and still require revisions. This has been the reason that immediate implant reconstruction hasn't been widely adopted. Alloderm allows greater control of the shape and more freedom to release the pectoralis muscle at the bottom.
Will this be effective? I'm not so sure. My impression is that you will be sacrificing the aesthetic result in many cases to avoid a second operation, which may in fact be unavoidable in many cases. I'm sure willing to try this on people who are interested, as I've already embraced the advantage of nipple-sparing mastectomies.
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