Development and Evaluation of an Injectable Acellular Dermal Matrix for Breast Reconstruction.

Breast reconstruction following oncoplastic breast-conserving surgery (OBCS) presents significant challenges, particularly in cases where conventional volume displacement techniques are insufficient. While autologous flaps offer an alternative, they are associated with donor site morbidity and surgical complexity. Acellular dermal matrix (ADM) has emerged as a promising volume replacement option, but its application in direct defect filling remains largely unexplored. This study introduced SC Fill paste, an injectable, microparticulate ADM developed through supercritical carbon dioxide (CO2) decellularization, micronization, and dispersion, ensuring easy application and adaptability to irregular defect geometries. In vitro and in vivo assessments demonstrated efficient host tissue integration, preservation of the extracellular matrix (ECM) and essential growth factors, and minimal inflammatory response due to low double-stranded DNA (dsDNA) content and the absence of major histocompatibility complex (MHC-I) proteins, as confirmed by Western blot analysis. Additionally, SC Fill paste exhibited enhanced fibroblast infiltration and neovascularization and reduced capsular contracture compared to commercial controls. Matrix metalloproteinase (MMP) activity and collagen expression indicated a consistent six-month remodeling effect, ensuring long-term stability. These findings provide strong preclinical evidence supporting SC Fill paste as a versatile and effective reconstructive filler, offering a practical and adaptable solution for post-BCS defects.