Soft Tissue Contouring with Acellular Dermal Matrix Grafts

Abstract

Introduction: Acellular dermal grafts have been used extensively in the treatment of burn patients to replace lost dermis in combination with an overlying thin-skin graft. This study reports on the use of acellular dermal matrix grafts (AlloDerm) for soft tissue contouring of the face. Placement of grafts subcutaneously has resulted in successful enhancement of facial areas such as lips, forehead, tear trough deformity, acne, depressed scars, and nasolabial folds. Materials and Methods: Acellular dermal matrix grafts with biocompatible properties have been used in the treatment of burns, in plastic/reconstructive procedures, and in periodontal surgeries (AlloDerm acellular dermal graft, LifeCell Corporation, The Woodlands, Texas). AlloDerm is processed from donated skin procured by skin and tissue banks in the United States that comply with standards set forth by the Food and Drug Administration and the American Association of Tissue Banks. All donated materials are thoroughly screened serologically via culture for fast-growing microbes; donors are screened serologically for human immunodeficiency virus 1 and 2 (HIV-1 and -2); human lymphotrophic virus 1 (HTLV 1); hepatitis A, B, and C; and syphilis. Eighty-five procedures using the acellular dermal graft were performed on 39 patients with follow-up from 9 to 18 months. Patients with autoimmune connective tissue disease were excluded from receiving the graft. Conclusions: The study patients reported on here exhibited unique postoperative courses with this biological implant, these courses were characterized by initial swelling and contraction and then by either expansion and augmentation or else resorption. Short- and long-term postoperative observations are described, with a focus on the methods used to achieve optimal graft results. Acellular dermal matrix grafts make an excellent soft-tisue augmentation material. The process of tissue integration or remodeling of the matrix using the patients's own tissue makes this a very exciting implant.