Breast Augmentation with Use of Strattice and Distortion

I will be having a breast sugmentation redo in the near future, and my new PS suggested using Strattice to help support my new implants. My question is about distortion when I flex my pec muscles. Will tacking the crease and muscle together with the Strattice increase the distortion when I flex?

Doctor Answers 10

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

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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.


Strattice can help minimize flexion distortion, shouldn't make it worse

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I have been using acellular dermal grafts for 10 years, and the development of Strattice for augmentation revisions has been very helpful. The flexion distortion that can occur after submuscular implant placement is due to the fact that the muscle has been cut off of its attachment to the ribs, which is necessary for the dual-plane procedure. This results in a free muscle edge in front of the implant, where it heals into the scar capsule. Flex the muscle and it pulls on the capsule, distorting the breast. With Strattice, one edge is sewn to the muscle and the other to the bottom fold of the pocket, so it eliminates that point of traction, while at the same time providing coverage and support to the bottom of the breast implant.

Breast augmentation with use of dermal matrix and distortion.

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Hello! Thank you for your question!  A capsulorrhaphy would be needed for revision of your breast pocket. If you do need such, the use of a dermal matrix or mesh may be considered if your tissue now has significant laxity that is failing in support or a significant deformity in which recreation of the breast pocket is required along with adding additional support and coverage of the implant.  Certainly, the larger the implant, the heavier the weight...thus, it may be useful to consider placement of a matrix or mesh. Otherwise, capsulorrhaphy for pocket revision using your native tissue should suffice.  It has been used safely and effectively to correct synmastia, restore the inframammary fold, mask implant issues (e.g., rippling, wrinkling, etc.), and improve aesthetic results in revisionary breast implant and reconstructive procedures.  However, only by physical examination would one be able to make recommendations on the benefits over the risk of using a matrix or mesh in your situation.  Use of the dermal matrix should not increase breast animation, which is an unfortunate event following some submuscular breast augmentations.  The only true means of correcting this issue is to change the position of the implant to one above the muscle.  

Consult with a plastic surgeon well-versed in breast procedures and the use of dermal matrices and mesh in breast procedures who will assist you in determining which procedure(s) would be the best for you.

VIDEO: Implant distortion with muscle contraction: dynamic breast deformity

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Unless you place the implants above the muscle, it is nearly impossible to avoid the distortion that occurs with muscle contraction. When the strattice is used the attach the muscle to the crease, it can minimize the distortion of the breast tissue but still cause displacement of the implant laterally with contraction.See linked video.

Acellular cadaveric dermal grafts (Strattice or Alloderm) has no effect on pec flexion

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Unless you are a postmastectomy reconstruction patient, the use of (ACD grafts) Strattice or Aloderm should neither improve or worsen pectoralis muscle flexion. For the past 6 years, I have used both Neoform, Alloderm and Strattice of inferolateral sling stabilization, camouflaging of inferolateral implant wrinkling and as an adjunct to capsulectomy in revisional breast implant patients.  The results have been very satisfactory and long lived.

The postmastectomy patients may still appreciate some pectoralis flexion, because their skin brassieres are by definition, thin.  good luck 

Lavinia K. Chong, MD
Orange County Plastic Surgeon
4.8 out of 5 stars 58 reviews

Secondary Breast Augmentation with Alloderm or Strattice

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The Alloderm or Strattice is being used to help support your breast implant.  You have have not included pictures which would be helpful in giving you more specific advice.  However, if during your initial operation the implants ended up too low or misplaced, then using Alloderm or Strattice in a secondary operation may be very useful.  The flexion deformity will not be affected significantly from the Alloderm or Strattice.  Good luck.

Breast augmentation with use of Strattice/Alloderm and distortion

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The use in a redo augmentation of Strattice will not effect whether you will have the muscle flexion distortion or not. There is no relationship.

Sorry from MIAMI DR. B

Strattice and implants

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I assume this is a redo because of either bottoming out or rippling.  The strattice will have no effect on the pec flexing.

Artifical Dermis (Alloderm Strattice) and Breast Augmentation

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Revision breast augmentation is a challenging operation and acellular dermal matrices have been very helpful in treating challenging situations.  These serve to help reinforce the breast crease, camouflage visible implants and correct malposition to name a few.  There are some risks with this procedure, however.  Animation deformities are possible with any subpectoral augmentation as the muscle may move the implant, this would be difficult to predict with the use of a dermal matrix.  However, since most patients who require this treatment do not have enough of their own tissue, visibility of the implant is possible as well.  In the right candidate this can be a very successful solution.

Breast Augmentation and Strattice

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I wouldn't worry about any sort of flex deformity from using the Strattice. In reality, it should be the same whether you have the strattice or not. The strattice will support the implant and keep it from falling more then desired.

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.