Options for internal bra for implant support
Each situation is a little different, so it is not possible to say which material is best. Acellular dermal matrix materials (Strattice, Alloderm) have been in use for many years and have a good record of success. Newer materials such as SERI Scaffold and GalaFLEX are becoming more widely used as clinical experience accumulates. My longest follow up with SERI is about 2 years now and it seems to be working well. When there is thinning of the tissue envelope around the implant, adding a layer of coverage and support with an internal bra material is the key to success.
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Use of ADM for breast revision and implant malposition
The short answer is yes.. ADM and surgical meshes have been very useful in correcting severe cases of implant malposition and bottoming out.
Breast "Mesh" best for revisions - #breastimplants
Breast "mesh", whether it is Siri or Stratice, requires an expensive material and significant time and surgeon effort to place well. So, using the device is a costly endeavor reserved for when there is not adequate tissue strength or thickness to repair a drop out that has already occurred. There are techniques to minimize an initial drop out, but implant size, chest shape, and breast shape all contribute to make some patients more high risk than others.
Breast Mesh or other devices to prevent bottom out.
There are techniques to correct a low or "bottomed out" breast implant. The Seri mesh is just one of them and is receiving much attention. In studies the mesh is effective in correcting breast pocket issues, both to the side and bottomed out. Correction is the key word as there is no indication for the use of mesh to prevent the problems. A well performed augmentation is the best "prevention".
Is their enough evidence to prove that a breast Mesh or other devices to prevent bottom out really is successful?
That technique has proven to be very helpful in some circumstances but is probably overused. I have rarely seen the need for that as other techniques are available.
ADM is used for correction of bottoming out after breast augmentation but there is no guarantee.
ADM is one of the potential modalities used to help sport the breast implant in women that experiencing bottoming out. This is a complicated issue and should be discussed with you carefully by her own surgeon.
Preventing Bottoming Out
Thank you for your question. Prevention is the best solution to bottoming out. By avoiding implants that are too large for your breast and frame as well as over dissection, this problem is largely avoidable. Once it occurs, replacing the implant with a smaller implant to reduce the weight and reinforcing the inferior pocket with sutures and a dermal substitute are the best options to control the pocket. Best wishes.