Dr. Teitelbaum's opinions on management of these cases has been sought after by many plastic surgeons around the country, and his email inbox often contains advice requests from surgeons on the applicability of ADM for patients in their practice. He has been referred many difficult cases requiring ADM by colleagues in Southern California. Manufacturers have asked his advice in developing future products and in devising the operations to use them.
Weak or inadequate tissue is the most vexing problem in breast revision surgery. If the tissue is thick, there is almost no problem that cannot be fixed. On the other hand, nearly all of the unsatisfactory outcomes in revision breast augmentation are a result of thin, weak, or damaged tissue. Thus, efforts to thicken and strengthen the tissue are very important.
Some plastic surgeons with extensive ADM experience have anecdotally noted a very low incidence of capsular contracture in patients who received these products. Dr. Teitelbaum has been offering Strattice™ and Alloderm® to patients with recurrent unsatisfactory results.
Strattice™ is derived from the skin of specially raised pigs, and Alloderm® comes from human cadavers. Some women are uncomfortable with these sources and decline using them despite any benefits they may offer for them. Others feel compelled to do whatever they need to improve their problem. And others are comfortable knowing that hundreds of thousands of women received cow derived collagen injections into their lips and that millions more received pig insulin for treatment of their diabetes.
Another issue for many patients is that these products can add thousands of dollars to the cost of a revision breast surgery. However ADM remains the only solution for some of the most difficult, frustrating, deforming, and embarrassing problems after breast augmentation surgery.
Dr. Teitelbaum has many patients whose process of operation after operation with dissatisfying results were finally fixed with the proper and careful use of ADM. At a consultation his patients receive a thorough analysis of their situation and an understanding of the applicability of these products for them.
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