I received a lift and breast argumentation June 3 2011. I received 275 cc of silicon in each. However, I feel I am bottoming out. I nursed two children up to 2 years and feel my skin has lost its elasticity. Do you typically pay extra for this repair? Do you think I need the strattice repair?
Do I Need Strattice Repair for Bottoming Out? (photo)
Doctor Answers (14)
Breast implant bottoming out
The simplest solution to your problem is to remove the implants and have the lift revised. Your breasts will certainly be smaller, but I think they will still be a nice size. More importantly, they will have less of a tendency to bottom out and the result will hold up better over time.
Recurrence of skin laxity over time the rule
Thank you for your question and the photos. From what you describe and show your results do look good. You may still have some laxity of your skin and may benefit from some additional tightening. Return to see your surgeon to discuss the options/possibilities of revisions or further surgery. Also, be informed the if you nursed two children and had a lot of excess/lax skin, that recurrence of skin laxity is the rule and not the exception. Breast lifts do not last forever and the weight of implants can cause a more rapid drop. Even if you have Strattice or some other type of acellular dermal product for suspension, it will not address the extra skin. The extra skin usually has to be removed with further thightening. I hope this helps.
I Had a Lift/Augmentation 7 Months Ago, Now I Believe I Bottomed Out. What's Your Opinion? Do I Need Strattice Repair? (photo)
The posted photos show a slight loosening inferiorly. I recommend you consider a revision lift first before use the acellular dermal mattrices, very expensive.
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Breast surgery fees
In can be difficult to measure out the amount of skin to be removed when doing a breast augmentation and lift together. Frequently some minor revision is necessary to fine tune the result but that is much better than if the surgeon took out too much skin the first time. In some cases the skin just stretches even if the surgeon took out sufficient skin the first time. In either case your best and cheapest option is to return to your original surgeon. You will need to pay some costs out of pocket, at least the operating room and anesthesia, but you will pay significantly more if you go to a different surgeon. It is more likely that you only need some additional skin removed but your surgeon is in the best position to make that call.
I hope you realize that this format of posting questions and receiving answers lacks the face to face direct communication required for you to make an informed decision regarding your surgery.
My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.
Breast Augmentation Mastopexy
It appears you have had a breast lift / mastopexy along with your breast augmentation. It has been reported in our journals that the lower incision of the mastopexy will increase in length or stretch a full inch during the first six months following the mastopexy. The angle of your 2-day post op photo versus the current photos at seven months is slightly different. The reason patients have a breast lift in the first place is because they have "stretchy" skin. So, the stretchiness quality of your skin envelope around the breast and the ligaments within your breast will always be there, even if you do further surgery. That said, I would revisit this concern with your surgeon. All the best, "Dr. Joe" Gryskiewicz
Your photos are not ideal to really comment because they were taken at an unsual angle. However, it looks like you just may have some rebound laxity of the lower pole. This may just require a revision to tighten the envelope. Good luck.
Strattice internal bra for stretched out lower breast
When the length from the nipple to the bottom fold of the breast elongates, it is often called a stretch deformity although calling it a deformity is probably too strong a term. Although no one can make a definitive recommendation without seeing you personally, issues such as this are the types of things that a Strattice internal bra corrects nicely. It is caused by the tissues not being strong enough to support the implants and breast tissue, so a revision of the lift might not be enough.
Did I Bottom Out after Breast Lift & Augmentation
Overall, your results look nice but the lower skin may have stretched a bit. If you don't like the result, your surgeon may offer a revision but given how large your breasts are, I suspect the improvement may not last long.
Lost elasticity, or bottomed out
We cannot see the breast fold well, however the long nipple to fold distance suggests laxity in the breast envelope rather that a low or bottomed out breast implant. Reducing the breast envelope through a second mastopexy, perhaps a 'T' pattern, might hold the breast firmer and higher.
Best of luck, peterejohnsonmd.com
Solutions for breast dropping after surgery
The shape evolution of your breast after surgery is quite common and is often unpredictable. Your tissue (breast tissue and skin) has stretched in response to the tension that was created purposefully in the operating room to improve your shape. Even though the implant size was appropriate for your breast the additional weight of the breast implant likely contributed as well.
Simply re-tightening your breast with a revision of your breast lift will create short term improvement but it is likely that your breast will slowly stretch back out. Removing some of your lower breast tissue and adding a similar amount of breast volume with a larger implant once again will not produce predictable long term shape maintenance. Adding a tissue substitue like Strattice is not the solution as your breast tissue and breast skin will still have the same properties and tendencies to stretch.
My advice would be to allow final healing and shape evolution to take place over the next 6 - 12 months. I would recommend a reduction of your lower breast tissue at the same time and no change to your implant size. The goal would be to achieve a more uplifted, younger and less heavy looking breast.
I would not be willing to use a larger breast implant as part of the solution but only you and your surgeon can discuss the options and the risks and costs associated with further surgery.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.