Does a breast implant that has fallen below IMF fold need revision using strattice in order to prevent dropping again?

The answer depends on why the bottoming out occurred. It is typically because the tissues thinned leaving inadequate support, and this happens more often with large implants. However yours are not especially large and since it only happened on one side, you might be able to get by with capsule repair (capsulorrhaphy) alone. Galaflex mesh is a less expensive option than Strattice, though Strattice has a longer record of clinical use for this application.

It's possible to correct bottoming out with a repair of the capsule alone or in combination with mesh support such as Strattice (permanent) or Galaflex (resorbable). Exam of your tissues and photos would be important to give you more recommendations. Consult with a few surgeons in person for a detailed exam.Best wishes,Dr.Bruno

Thank you for your excellent question!  Strattice is definitely not your only option.  It sounds like you have a very realistic plan to address this issue.  Hopefully you can get away with a capsulorrhaphy to close off the pocket.  I recommend that you consult with a board certified plastic surgeon in your area to discuss your options.  I wish you the best of luck!

Dear huckfc,
bottoming out occurs when the implant falls below the current breast crease or inframammary line. It's more likely to happen with inframammary incisions, which is why I try not to use the inframammary approach to any breast surgery.
Bottoming out can also occur if an implant is too large for the breast pocket. That is why it is important to choose an implant size that's correct for your body. I perform numerous measurements in the office to determine optimal implant size for my patient's bodies.
If you are concerned, please check it with your plastic surgeon for reassurance and to further discuss your options and possibility of revision.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

To address a bottoming out issue, the fold is brought up either by capsulorrhaphy which means tightening the scar tissue at the bottom,  placing ADM (acellular dermal matrix) like Strattice and/or using other product like Galaform/Galaflex to help secure the fold and the implant.It all depends on the surgeon and the patient.  If the soft tissue can support simple suturing then that should be enough.  But in most cases the bottoming out has happened because the patients tissues are not able to support the weight of the implant.  In your case you do have a smaller implant, so perhaps capsulorrhaphy may be sufficient.  It is difficult to tell without and exam.I would recommend you consult with a board certified plastic surgeon to discuss your surgical options.Hope that helps.

I am sorry to hear about the problem you are having after breast augmentation surgery. 
 Generally, signs of breast implant bottoming out include: 
1. Breast implant "sits" too low on the chest wall.
2.  Excessive palpability or visibility of the breast implant along the lower breast pole.
3.  Nipple/areola complex seems to be sitting relatively high, because the breast implants have settled too low. 
4. Discomfort along the lower breast pole (secondary to pressure from the underlying implant).
5. Relative paucity of upper pole breast implant volume compared to lower pole volume.
6. Increased visibility of a infra mammary fold scar (higher on the breast mound).
 Patients who experience bottoming out of breast implants typically benefit from revisionary breast surgery which will likely involve capsulorraphy ( internal suture repair). Sometimes, depending mainly on the patient's history and physical examination, I will also use additional supportive materials such as acellular dermal matrix or biosynthetic mesh. 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 and visibility of the inframmammary fold scars (if present) should improve with this operation.
There are several important "factors" involved in this type of revisionary breast surgery. Most important (in my opinion): plastic surgeon experience level.     In other words, experience level and technical expertise play the biggest role when it comes to successful  outcomes with this type of revisionary breast surgery.   Careful attention to postoperative activity limitations as well as use of appropriate postoperative support of dressing/garments are also important.
 I hope this helps.

Thank you for the question but an examination is really needed.  So go on some complimentary consultations with experts and compare recommendations after a full examination and discussion of desired results.  That said a pocket revision alone may correct the problem with or without an ADM like Strattice for reinforcement Dr Corbin