I have used Seri scaffolding several times and feel that there are a few distinct advantages to this ADM verus Strattice. And in cases requiring capsular suturing/reinforcement, use of this graft appears to be helpful in creating a result that is more durable in the long run as compared to direct suturing alone.
As for upsizing, the degree of upsizing really depends upon where you are starting out, your tissue quality, and ultimately your desired look.
I hope that helps!
SERI Scaffold appears to have long-lasting results, but there is less data on its role in capsular contracture surgery as compared to ADM's like Strattice. It is considerably less expensive than Strattice however and I believe that in many cases the results are more successful as compared to internal stitching alone, especially when going larger and removing the capsule for contracture.
These are great questions. There is really no evidence that suggests that capsulloraphy alone (i.e. suture the pocket closed) is really any different than supporting the tissue some sort of commercial product. Nonetheless different surgeons have different philosophies about this. The common issue here is the integrity of your skin and your choice to go larger. In my experience is somewhat has relatively good skin and a relatively solid pocket, I use a capsulloraphy alone. More often than not, patients that require extensive breast revision have a defect in the integrity of the tissue. In these cases I place some sort of tissue support. This is particularly important if someone has a recurrent capsular contracture and desires to go larger (as in your case). In my practice here in San Diego, I performed an extensive amount of breast revisional surgery. I would have to say that my greatest success is with the use of Strattice BPS. In my experience, this provides an excellent support for tissue, reduces the risk of capsular contracture and has minimal risk of infection. This product has excellent revascularization and incorporates as your own tissue very quickly. there are other types of products including synthetic mesh is as well as silk mesh such as Seri-scaffold. in my experience, Strattice works the best.The one down side is cost. These products are fairly expensive.