Alloderm in New York

This is one of the newer types of implants. Alloderm is a material made from human skin. It is obtained through tissue banks in the United States which surgically remove a thin layer of skin from dead donors using sterile operating room techniques. The skin is placed into an antibiotic solution and then sent for processing. This involves removing the epidermis (top layer of skin cells) and all of the cells in the dermis (deepest layer). The remaining material is a collagen framework, which provides strength to the skin. There are thus no components left to cause the rejection or inflammation that can result with unprocessed tissue transplants. Therefore, when transplanted to a patient, the Alloderm graft gradually incorporates or binds to become a natural part of the patient's own tissues and performs like normal healthy tissue thereafter.

Are Alloderm grafts safe ? Before any processing of the skin takes place the tissue donors undergo rigorous screening by the Tissue Bank. The donor's medical and social history and cause of death are carefully reviewed and documented. The Tissue banks or a certified laboratory using FDA-licensed tests extensively tests Blood samples. The donor must be found negative for Hepatitis B and C, HIV types 1 and 2 antibodies (screening for AIDS) and syphilis. Its important to understand that human pathogenic viruses, including HIV, require certain types of human cells to be present and alive in order for the viruses to live and grow themselves. These viruses essentially are "parasites" of cells and cannot reproduce without them. The alloderm process removes all cells, thereby removing the components necessary for the survival and transmission of these viruses. Additionally, after cell removal the Alloderm grafts are freeze-dried. As an extra safeguard, Alloderm grafts undergo microscopic and other analytical testing, both before and after processing, to rule out pathogenic contamination and promote uniform quality.

How long has Alloderm been used? Use of Alloderm began in 1992 for burn patients and in 1994 for periodontal and plastic surgery. Currently more than 50,000 patients have received Alloderm grafts.

What are the advantages of Alloderm ? Alloderm is the only available product capable of regenerating normal soft tissue. Since it is human tissue it does not incite an inflammatory or allergic reaction, and the pre-treatment skin testing required with animal collagen is not needed. Also the graft does not have the feeling of hardness that is reported with many synthetic material. When Alloderm is used as an implant, it thus completely eliminates any need to take donor fat or dermis from one part of the body to transplant to another area and thereby eliminating further scars.

What are the disadvantages of Alloderm ? Despite the thorough processing which Alloderm undergoes, rendering the implant devoid of most cellular components, some people may still be averse to the thought of having "someone else's skin" inserted into theirs. Although Alloderm appears to be long lasting, with initial studies confirming up to 2-year survival rates of the graft, longer term and larger studies are needed to determine whether or not Alloderm is indeed permanent. There have been reports of a small number of patients completely absorbing the volume of Alloderm within 6 months of surgery. Alloderm lip enhancement is irreversible after a period of 7-8 weeks. This is due to the incorporation of Alloderm to your own tissues, and therefore any attempt at removal of the Alloderm is extremely difficult or in fact impossible after this period of time.

The Procedure : Surgery is usually performed as a day case under local anesthetic with the aid of some sedation or "twilight anesthesia. The Alloderm graft, which comes freeze-dried, is re-hydrated in a sterile solution. This makes it very soft and pliable and in fact feels just like your own tissue. The graft is then rolled into a tube, to a thickness depending on how much fuller the patient wants to be. Tiny incisions are then made inside each corner of the mouth. A tunnel is then created under the skin of the lips and the Alloderm is then threaded through. A single suture is then used to close the incisions and an antibiotic ointment is applied over these for the next few days until the incisions are healed. You will also be prescribed a short course of antibiotics to minimise infection risk.

Postoperatively : Following surgery you should expect to have a "bee stung" appearance due to the swelling. There may also be some bruising. Cold compresses to the lips in the first few day's helps to lessen this. Although much of the swelling will be gone with a few days, the healing process will continue. This may take up to 2 months. During this period the graft sometimes feels slightly firm. Firmness may persist longer if you develop a postoperative infection, react to the suture material or if you had other materials previously implanted or injected into the same area. As the graft heals and becomes a part of your own tissue, it softens and in several months should feel no different that the surrounding skin. It is important to bear in mind that Alloderm becomes incorporated into your own natural tissue. This process will be significantly advanced by about 2 months. Therefore should you wish to have the implant removed for whatever reason, then this must be done by 5-6 weeks postoperatively or complications may arise if this is undertaken at a later stage.

What are the risks ? As with any operation, risks such as bleeding and infection can occur. People who are prone to developing cold sores may develop an exacerbation following this type of surgery. If this were to happen then you would be given tablets and ointments to treat the cold sores which should not alter the overall result. There may also be slight asymmetries of the lips, scarring, firmness of the graft, and changes in sensation (temporary).