Tissue expander breast reconstruction using prehydrated human acellular dermis

Vinay Rawlani, Donald W. Buck, Sarah A. Johnson, Kamaldeep S. Heyer, John Y.S. Kim

Research output: Contribution to journalArticlepeer-review

60 Scopus citations


Introduction: Human acellular dermal matrices help facilitate immediate tissue expander-implant breast reconstruction by providing support to the inferolateral pole, improving control of implant position, and enhancing early volume expansion. Although several freeze-dried human acellular dermal products have demonstrated reasonable safety and efficacy in immediate tissue expander-implant breast reconstruction, no dedicated studies have evaluated clinical outcomes of prehydrated human acellular dermal matrix (PHADM) in breast reconstruction. Methods: The outcomes of 121 consecutive tissue expander reconstructions performed by the senior author using PHADM were evaluated. Results: Mean intraoperative tissue expander fill volume was 256.6 ± 133 mL, 60% of final expander volume. Patients required an average of 3.2 additional expansions prior to tissue expander-to-implant exchange. Mean follow-up period after reconstruction was 44 ± 26.5 weeks. Complications occurred in 20 (16.5%) breasts, including 9 (7.4%) soft-tissue infections, 8 (6.6%) partial mastectomy flap necroses, and 2 (1.7%) seromas. Eleven (9.1%) breasts ultimately required explantation. Patients receiving radiation demonstrated a strong trend toward greater complications (30.8% vs. 13.7%, P = 0.0749). Conclusions: The outcomes and complication rates of PHADM tissue expander breast reconstruction are comparable to those reported with freeze-dried human acellular dermis.

Original languageEnglish
Pages (from-to)593-597
Number of pages5
JournalAnnals of Plastic Surgery
Issue number6
StatePublished - Jun 2011


  • FlexHD
  • acellular dermis
  • breast reconstruction
  • tissue expansion


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