Focus on technique: two-stage implant-based breast reconstruction.

Acellular dermal matrix has become a frequent adjunct to traditional expander-based breast reconstruction. Its putative advantages include improved positioning of the prosthesis, better definition of the inframammary fold, amelioration of potential contracture, and overall enhancement of cosmesis. Concomitantly, there may be an increased risk of seroma, infection, and reconstructive failure. A thorough review of the techniques and outcomes of two-stage acellular dermis-assisted breast reconstruction was performed. Key technical aspects of two-stage acellular dermal matrix-based reconstruction are presented. Indications, techniques of handling and inset, and select strategies to avoid and manage common complications are discussed. Evidence-based outcomes are reviewed. Acellular dermal matrix-based two-stage reconstruction continues to evolve as a viable option in breast reconstruction. Future studies will better delineate the risks and benefits of the technique.