Would An Alloderm Graft For A Soft Tissue Shoulder Defect Be Permanent?

Q: Dr. Eppley, Thank you for your reply!. Alloderm seems to be a great option!. For the measurement of the shoulder atrophy, it’s very asymmetrical and not a perfect round shape. So this area (of skin atrophy / fat atrophy) is around in height 8 – 10cm and in width around 5-6cm (sorry its hard to measure it) It will be so amazing and my dream if i can find a permanent solution, and feel normal…

After alloderm graft, will the result be permanent? Like if for example i lost weight, do sport, or get old?. And I have heard that Alloderm can be resorbed over time, is that true?

Thank you so much for your kindness!

A: Thank you for sending your measurements. The purpose of the measurements is help select what size Alloderm or Strattice sheet (both are tissue bank dermal grafts) is needed or what the dimensions of the implant would be if we where going that route.

My extensive experience with Alloderm in the face as well as the breast is that it is volumetrically persistent. Whether that translates to the shoulder for your type of problem can only be speculated as who has ever done it before? Alloderm is used extensively in breast reconstruction as a lower sling to support an implant and as a reinforcing sling in aesthetic breast surgery for bottomed out breast implants…situations where its persistence is important. Whether the high motion area of the shoulder will share a similar long-term outcome is presumed. While a custom soft silicone implant will undoubtably provide long-term volumetric maintenance my long-term concerns with its use in the shoulder is eventual edging of the implant being seen and/or an unnatural folding of the implant when you raise your arm., Thus it is better to have something that will allow tissue ingrowth and a few less risk of graft edges being visible.

Dr. Barry Eppley

Indianapolis, Indiana