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Strattice for Breast Augmentation Revision to Prevent Movement into Armpits

I have 10yr saline, under muscle(325ccs)implants. 5'1, 99lbs, AA before surgery. Shortly after surgery they began to move into my armpits and its gotten worse over the yrs. New PS says go with smaller silicone implants and use strattice.

Do you all agree? It's quite expensive and I dont want any regrets. How long is drain necessary with strattice? Also, I want a little smaller, but not too much. Is it safe to go close to the original size? 

Doctor Answers (12)

Strattice Can be Helpful for Breast Surgery Revision

+4

Strattice can be helpful in breast revision surgery:

  1. The Strattice can help by creating an internal support to prevent a recurrence of the displacement of your implants toward the armpits.
  2. It can also be helpful in minimizing wrinkles from an implant in slender women.
  3. There is some evidence that Strattice may lower the incidence or recurrence of capsule contracture.

It is a significant added expense in revision surgery, but may be well worthwhile if it prevents a recurrence of the problem.

The decision is not formulaic; without individual examination, it not really possible to recommend individually.

And be prepared: experts may disagree!

Web reference: http://www.drzwiebel.com/denver-breast-augmentation-breast-implants

Denver Plastic Surgeon
4.0 out of 5 stars 5 reviews

Avoid Stratice! Your own body has a much better structure: Fascia intelligent use of the subfascial plane is the answer

+3

Avoid Stratice! Your own body has a much better structure: Fascia intelligent use of the subfascial plane is the answer

 

Avoid Stratice!  Your own body has a much better structure: Fascia intelligent use of the subfascial plane is the answer

 

The problems that lead to suggested use of Stratice and dermal fillers are way too common.  The reality of breast augmentation is that most women have similar results and are simply not aware that there is a better option.  The most commonlyt used technique is the  "dual-plane" subpectoral placement.  this sets up the implants for lateral and inferior malposition.  The top of the breast has muscular coverage and because of the pectoralis major's origination next to the sternum, the implants are pushed away from midline creating the valley between them that you dislike ( I call this the Miami Valley based on the common augmented look of breast augmentations in Miami).  Because the inferior portion of the breast is subglandular,  there is no support and the implant tend to migrate toward the armpits then down.

 

For these reasons I do not perform submuscular or dual-plane breast augmentations.  I use a technique that I call "Cold-Subfascial Breast AugmentationTM" that overcomes the shortcomings of dual plane.  By leaving the muscle alone and precisely lifting the strong pectoralis fascia,  I am able to custom design what is essentially a living natural brassiere to support the implant within the breast.  Using this technique I am able to create beautiful natural appearing breasts that complement the individual patient's body.

 

I commonly revise patients in your position by converting them to the cold-subfascial plane.  In my experience this is the only way to repair the breast and create a long-lived beautiful result.  Artificial materials such as stratice are just asking for trouble in my opinion.  I hope this helps!

 

 

All the best,

 

Rian A. Maercks M.D.

 

Web reference: http://www.rianmaercksmd.com/before-after-photos/Breast-Surgery/Breast-Implant-Revision/case153.html

Miami Plastic Surgeon
5.0 out of 5 stars 29 reviews

Strattice in breast implant revision

+3

Strattice is an 'allograft' actually pig skin and the role in breast augmentation revision is controversial. Don't expect surgeons to be on the same page on this one. Our feeling is that the role, possible in reduction of capsular contracture is not defined. It has been marketed to hold implants in position and prevent 'bottoming out' though again has several drawbacks, and for most may be unnecessary. Get additional opinions. My vote would be to focus and revising the shape or location of the pocket alone.

Best of luck,

peterejohnsonmd

Web reference: http://www.peterejohnsonmd.com

Chicago Plastic Surgeon
4.0 out of 5 stars 25 reviews

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Strattice and breast reconstruction

+3

While material like Strattice is in vogue, it is definitely not always necessary, not helpful. All procedures, surgical manuveurs, and products must be used judiciously, not indiscriminately or by rote.

Robin T.W. Yuan, M. D.

Beverly Hills Plastic Surgeon
5.0 out of 5 stars 6 reviews

Breast Augmentation Revision -- Consult is Critical

+2

Strattice for Breast Augmentation Revision -- to use or not to use -- is that the question?

Other surgeons here have given varying opinions about using a material such as Strattice. The reality is that there is not a single answer. While purported benefits of using Strattice include situations such as yours (thin tissues and need for additional reinforcement of the implant pocket), it really comes down to an assessment of your own tissues to determine what we are working with.

Your surgeon has made a recommendation to use Strattice and to downsize your implants. This sounds reasonable. And without being able to examine you, I wouldn't be able to make a different recommendation.

While your are quite thin, I have had other thin patients that have had great success with revising an implant pocket without the use of Strattice, particularly when using a silicone implant. I also feel that using silicone gel implants and downsizing both weigh a bit against using Strattice.

Hope this helps,

Nick Slenkovich, MD FACS

 

 

Web reference: http://www.coloradoplasticsurgery.com/breast-augmentation.aspx

Denver Plastic Surgeon
5.0 out of 5 stars 39 reviews

Strattice and Breast Augmentation revision

+2

In my practice we have used Strattice to help with capsular contracture, thin skin issues and implant displacement.  It is expensive but if you consider it over the long haul, and the fact that it corrects the problem ... it is worth it.   There are no other options at this point for these issues. 

Pictures would help in your case to determine the most appropriate treatment for you.

A good board certified plastic surgeon will be able to assist you in your treatment.

Good luck to you.

 

Dr. Kimberly Henry

San Francisco ,CA

Web reference: http://www.drkimberlyhenry.com

Greenbrae Plastic Surgeon
5.0 out of 5 stars 2 reviews

Strattice helps breast implant revision if tissue reinforcement is needed

+2

Without personally examining you and discussing your goals, no one can give you definitive advice. It sounds like you are thin and the implants are large for your size, which can lead to stretching and thinning of the tissues around the implant and loss of support. If this is the case then the tissues would need to be reinforced and Strattice is a very good way to do that. On the other hand, if an revision is attempted and it fails, that can lead to even more thinning and a worse problem, not to mention spending more money in the long run than the cost of Strattice.

Seattle Plastic Surgeon
4.5 out of 5 stars 21 reviews

Strattice for Breast Augmentation Revision

+2

Very difficult to advise without an in person evaluation. Yes it is $2,000 more expensive and there are no guarantees. I use drains for 4 days to a week on average. Size is between you and your chosen surgeon.  

Miami Plastic Surgeon
4.5 out of 5 stars 55 reviews

Strattice can be helpful for breast augmentation revisions

+2

It is very difficult to comment on your case without at least seeing photos. Strattice is very helpful for many types of breast implant revisions and at this point i wont do certain cases without it (recurrent capsular contracture or fold displacements). Get a few consults from experienced revision surgeons. Disclosure - i am a speaker for lifecell - company that makes strattice.

Boca Raton Plastic Surgeon
4.5 out of 5 stars 23 reviews

Revisional breast in a runner

+1

Runnermomof3: I agree that choosing a silicone gel implant, which has a base diameter or "footprint" which is similar to yours, will produce a result which approximates the one you have now.  If your implants are 10 years old, I'll bet they were "standard" profile, which will overwhelm your frame.  You might ask your PS whether the intermediate or high profiles would be preferable. 

The space or pocket, in which your implant resides, must be made more narrow.  This can be done either by applying Strattice, as an inferolateral "hammock" or by simply suturing the lower outer aspect of the pocket with a permanent suture, in a technique called suture capsulorrhaphy.  Both Strattice and suture capsulorrhaphy have the potential to be painful but in the long run, really worthwhile.  If Strattice is used, the drain usually stays in until the output is 25-30cc/day and the patient must agree to restrict their activity for at least 2 weeks. 

So you could achieve this effect without Strattice, although I agree that it is a more reliable insurance policy against relapse.  Good luck.

Orange County Plastic Surgeon
5.0 out of 5 stars 30 reviews

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.

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