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.
Dr. Teitelbaum was a member of the national plastic surgery task force that developed the Covid-19 protocols for plastic surgery offices. He is therefore well-versed in all of the recommendations and his office meets or exceeds all of them. By now you are familiar with all the obvious measures such as reminding patients and staff not to come to the office if they have any symptoms, taking temperatures, maintaining social distancing, having everyone wear masks, placing hand sanitizers everywhere, reducing the number of patients in the office at one time, testing all surgical patients, etc. One unique feature is that Dr. Teitelbaum’s operating room has "laminar flow" – a very advanced system that directs the flow of air from a large diffuser on the ceiling to exhausts near the floor, ensuring that the fresh air flows in one direction. This not only reduces the chance of COVID infections for the patients and staff, but it also reduces the risk of surgical infections.
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