Is their enough evidence to prove that a breast Mesh or other devices to prevent bottom out really is successful?

Has their been enough evidence yet to prove that devices used to prevent bottom out breast really work ? And if so for how long ? Which device is best ?

Doctor Answers 8

Options for internal bra for implant support

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
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.

Seattle Plastic Surgeon
4.9 out of 5 stars 59 reviews

Use of ADM for breast revision and implant malposition

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
The short answer is yes..  ADM and surgical meshes have been very useful in correcting severe cases of implant malposition and bottoming out.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 20 reviews

Breast "Mesh" best for revisions - #breastimplants

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
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. 

Mark D. Wigod, MD
Boise Plastic Surgeon

Breast Mesh or other devices to prevent bottom out.

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
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".

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 44 reviews

Is their enough evidence to prove that a breast Mesh or other devices to prevent bottom out really is successful?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
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.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 29 reviews

Is their enough evidence to prove that a breast Mesh or other devices to prevent bottom out really is successful?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Most patients who undergo this type of revisionary breast surgery benefit from capsulorraphy (internal suture repair). This procedure serves to reconstruct the lower poles of the breasts and prevent migration of the breast implants too far inferiorly. Associated issues with positioning of nipple/areola complexes should improve with this operation. In my practice, I use a 2 layered suture repair, supporting the involved area. I do not find the use of acellular dermal matrix or mesh necessary for the majority of patients who present with breast implant displacement problems. Factors such as recurrence of breast implant displacement/malposition and the presence of poor quality skin/tissue support come into play when making a decision to recommend/utilize additional support materials.

Generally speaking, the use of acellular dermal matrix or bio synthetic mesh for patients in your situation may be helpful occasionally. This material may be helpful as a supportive matrix and help with the breast implant displacement/malposition you are experiencing. Again, I usually recommend their use depending on the patient's anatomy ( for example quality/elasticity of the involved skin) and past surgical history.

You may find the attached link, dedicated to revisionary breast surgery (demonstrating many cases of corrective surgery for patients with "bottoming out" of breast implants) helpful to you as you learn more. You will find a separate page, on the same website, dedicated to bottoming out situations specifically.
Best wishes.

ADM is used for correction of bottoming out after breast augmentation but there is no guarantee.

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
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

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
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.

George Bitar, MD
Fairfax Plastic Surgeon
4.6 out of 5 stars 59 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.