Introduction: Breast reconstruction is a common procedure for plastic surgeons and many require two stages. Unfortunately, problems may be encountered when reconstructing mastectomy defects with a two-staged procedure. Extrusion of the expander, infection, visible or palpable wrinkling of the envelope, asymmetry, malposition or lateral displacement of the expander, limitation of inferior pole projection and capsular atrophy continue to be problematic.

Materials & Methods: We report the use of human acellular dermis in 17 patients with 27 breast reconstructions after mastectomy. The rectangular dermal matrix sheet was sutured into the wound to create a covered expander.

Results: This dermal matrix provided complete muscle and dermal graft coverage of the expander, stabilized the expander in its position, prevented lateral migration and reestablished both the inframammary fold and the lateral breast margin. Histologic analysis in 5 patients demonstrated the AlloDerm to be well incorporated at an average of 11.5 weeks.

Conclusion: We found AlloDerm to be easily handled and positioned into the wound and helped avoid problems associated with two-stage breast reconstruction procedures such as extrusion of the expander, infection, wrinkling of the envelope, asymmetry, malposition of the expander, limitation of inferior pole projection and capsular atrophy.