Acellular Dermal Matrices in Aesthetic Surgery: Clinical Applications

Background Acellular dermal matrices (ADMs) are decellularized extracellular matrix scaffolds derived from human or animal dermis and are increasingly used as adjuncts in aesthetic and cosmetic plastic surgery. Objective This narrative review summarizes the mechanisms, clinical applications, safety considerations, and evidence limitations of ADM use in aesthetic surgery. Methods A narrative literature review was conducted using PubMed/MEDLINE and reference screening to identify clinical reports, comparative studies, systematic reviews, society assessments, animal studies, and histologic studies relevant to ADM incorporation, remodeling, capsule formation, and aesthetic outcomes. Results ADM applications in aesthetic surgery include facial contour camouflage, rhinoplasty soft‐tissue augmentation, lower eyelid spacer grafting, implant pocket control, implant camouflage, and selected management of capsular contracture in cosmetic breast surgery. The quality of evidence varies by indication. Facial and rhinoplasty applications are supported mainly by small case series, lower eyelid spacer grafting has comparative evidence including a prospective randomized study, and cosmetic breast applications are supported primarily by retrospective cohorts and large clinical series. Reported complications include seroma, infection, delayed integration, graft contraction, contour irregularity, extrusion, and cost‐related limitations. Conclusions ADMs may be useful adjuncts in selected aesthetic surgery patients when applied according to a clear anatomic or biologic rationale. However, stronger long‐term comparative studies, standardized outcomes, and cost–benefit analyses are still needed.