Using Strattice As Preemptive Measure Against Bottoming out in Lift + Augmentation? Doctor Answers, Tips
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Using Strattice As Preemptive Measure Against Bottoming out in Lift + Augmentation?

Have had three consultations and most recent PS who specializes in reconstructive surgery advised that my skin tissue is somewhat thinner than ideal and thinks that implants could easily bottom out within a year of a lift + augmentation. He suggested considering using Strattice to prevent skin from over stretching. I am 30, 5'5', 160 lbs, run daily so an internal reinforcement is of interest to me. prev 36DD now a small C, seeking full D. also getting full TT and lipo of flanks. Thanks!

16 Doctor Answers | Asked by I Still Exist in Atlanta, GA
+2

Can Bottoming Out Be Prevented with "Strattice"?

Strattice and Alloderm are brands of material that can be used in breast reconstruction to provide coverage and support to breast implants. This material, called ADM (acellular dermal matrix), can also used in fine tuning an aesthetic breast augmentation that requires added support or coveraget. It is not common to use it in an initial breast surgery. Its use is limited by its extremely high expense. If cost did not... more
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Using Strattice As Preemptive Measure Against Bottoming out in Lift + Augmentation?

This question has stirred many responses. Thanks for posting photos. From my view I would be more concerned about obtaining a large enough implant with a full mastopexy lift to end up a D cup. Bottoming out is more a secondary issue. If you want a higher % of avoiding this issue than you should spend the extra $2,000 or $3,000 to use an acellular dermal matrix. I might suggest a staged breast operation. Do the full mastopexy first, allow 3 months of healing than insert a 400 cc + implant... more
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Using Strattice As Preemptive Measure Against Bottoming out in Lift + Augmentation?Answer:

I feel lift patients need support, either from complete submuscular placement if the pt. desires no larger than a small-mid C or Strattice if she desires larger (LifeCell does not “recommend” Alloderm in cosmetic cases) sutured from the pec down to the chest wall. My experience is that any muscle release to try & accommodate a larger implant will drop, and the patient will lose upper fullness. So in larger lifts, I feel Strattice is a must. Expensive yes but cheaper than a... more
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Strattice for Mastopexy Augmentation

I have used Strattice in a number of mastopexy augmentations (as well as for capsular contracture and other revisionary breast surgeries). I also have given courses and am a speaker for Lifecell (the company that makes Strattice) - but these views are mine alone. You mentioned risk of bottomming out that concerns you. Bottomming out is when the fold is displaced to a lower position. This is a rare issue with mastopexy augmentations. The real problem is one of inferior stretch in which... more
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Usage of Strattice to prevent bottoming out of breast

Needing a lift in addition to the enlargement confirms your tissue's intrinsic loss of elasticity and predisposition to stretch with time. Clearly an adjunctive support such as Strattice would be of some help but the cost which can run into a few thousand dollars extra may not justify this. To help slow down the inevitable drooping and bottoming out with time, keep your implants on the smaller rather than the larger size; have them placed behind the muscle; religiously wear a... more
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Using Strattice in first operation

I have also thought about using Strattice in first time patients at high risk for implant malposition. This would be very expensive though. While I can't say for sure because I have not examined you, you look like your inframammary creases are well defined and these are the best barrier to implant descent. Don't go too big, do wear a well supportive bra 24/7 for at lease 3 months and don't do exercises that bounce the implants too much or use too much pec... more
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Bottoming out and the use of Strattice

Placing implants during a breast lift should provide you with good volume and good breast shape. I have not yet had to use any supporting membranes for a primary breast surgery. If the ligaments that support the breast crease are cut, such as during a mastectomy for cancer, then membrane support can be helpful. As long as the inframammary fold is not injured during surgery additional fold support with Strattice should not be needed.
+2

Strattice as routine with breast implants

The fact is that bottoming out of breast implants is quite uncommon, and even for capsular contracture Strattice and other allografts are very expensive, and will not always work. Your tissue does not look particularly thin and we would suggest you forgo the Strattice and have the implants without. Best of luck, peterejohnsonmd
+2

Breast lift, bottoming out

Although Strattice or any of the other similar skin products may help, it is quite expensive and doesn't always work. I have found in my patients with thinner skin that need a lift and augmentation, it often works well to 2-stage the procedure. We do a "vest over pants" type of lift to double the thickness of your own skin, then wait 3-6 months before putting in implants. This not only reduces the risk of... more
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BOTTOMING OUT

Bottoming out is a relatively uncommon event following Breast Augmentation. Strattice is a nice tool to be used in reconstructive breast surgery and revison surgery following breast augmentation. It is not commonly used as a preventive measure in primary Breast Augmentation. It will add significantly to the overall cost. Therefore, I would not recommend its use in your situation.
+2

Stratice to prevent bottoming out.

Hello, Some bottoming out will occurr with larger implants over time if the proper support (bra) is not worn. Strattice or other types of acellular dermal matrix products may help for some individuals. It is important to remember that: 1) This is also skin product and will also stretch 2) It is not cheap 3) If a circumvertical lift is done, a small revision down the road under local anesthesia to retighten the breast is easy to do. I say go without the... more
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Strattice with augmentation mastopexy

Generally strattice is used for revision breast surgery after bottoming out has occured. I am sure it can be used for the initial surgery but if it is not needed it could be a significant extra expense. Smaller implants will also decrease bottoming out. Donald R. Nunn MD Atlanta Plastic Surgeon.
+1

I vote No to Strattice.

I don't think this is a good idea. If the implants are not placed too low they should not bottom out. Lipo and TT will be a good combination for you. Good luck
+1

I would not recommend Strattice

You have very thin breast skin and would have higher risk of sagging with or without implant. I would recommend mastopexy and fat grafting for the first surgery and if you want to have even bigger breast,do the implant augmentation later.You have nice breast volume and may be happy with the lift and fat grafting for the upper breast and cleavage.
+1

Breast size affects running with our without implants

Running is limited by breast size (natural or implanted), and vice versa running directly affects the longevity of a given breast shape. Patients who run routinely should: Consider a breast size no larger than C. Larger breast sizes do not last, stretch and fall. There is no material that will prevent that if breast size exceed what the tissues can support. Avoid implants if starting breast size is C or larger. Larger skin evelopes tend to stretch easier... more
+1

Bottoming out should be very rare following breast lift/augmentation.

Hi. 1) Based on your story and your pictures, I would not recommend Strattice. In my opinion, bottoming out happens not because of tissue thinness but because of surgical technique. 2) When we do use a tissue matrix, we use Alloderm, because it is a human product. see video
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