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Comparison of Outcomes Using AlloDerm Versus FlexHD for Implant-Based Breast Reconstruction

Liu, Daniel Z. MD; Mathes, David W. MD; Neligan, Peter C. MB, BChir; Said, Hakim K. MD; Louie, Otway MD

doi: 10.1097/SAP.0b013e318268a87c
Breast Surgery

Background Prosthetic reconstruction using human acellular dermis (ADM) is a common practice in breast reconstruction. AlloDerm and FlexHD are two different forms of ADM, each with unique characteristics. No studies have directly compared the postoperative complications of these 2 products.

Methods The outcomes of 547 consecutive implant-based breast reconstructions were reviewed.

Results Reconstruction was performed in 382 consecutive women (547 total breasts), employing mostly immediate reconstruction (81%). Mean follow-up was 6.4 months. Among immediate reconstructions, 165 used AlloDerm and 97 used FlexHD. Complications were similar by univariate analysis. In multivariate analysis, smoking and higher initial implant fill were risk factors for delayed healing. The use of FlexHD, single-stage reconstruction, and smoking were independent risk factors for implant loss.

Conclusions There is no significant difference in the complication rates between AlloDerm and FlexHD in immediate breast reconstruction. Multivariate analysis suggests that FlexHD may be a risk factor for implant loss.

From the Department of Surgery, Division of Plastic Surgery, University of Washington School of Medicine, Seattle, Washington.

Received April 22, 2012, and accepted for publication, after revision, July 8, 2012.

Presented at the 50th Annual Meeting of the Northwest Society of Plastic Surgeons, Oahu, Hawaii, February 18–23, 2012.

Conflicts of interest and sources of funding: none declared.

Reprints: Otway Louie, MD, Department of Surgery, Division of Plastic Surgery, University of Washington, Box 356410 Seattle, WA 98195-6410. E-mail:

© 2014 by Lippincott Williams & Wilkins