Changing to Slightly Larger Implant Size After Strattice?

I had to have implant exchange and had a strattice "sling" placed in both breasts one year ago. It is unclear what went wrong, but now one breast is bottoming out. My surgeon suggested yet another piece of strattice on the bottoming out side. I am not thrilled with the size or for that matter the placement of the the implants. My question is, is is considered a risky move to increase and change a pocket once strattice has been in place for a year? My incisions are under the breast.

Doctor Answers 6

Bottoming out

Sounds like your situation is complex and it's difficult to give advice without examining you (or seeing photos). Best to discuss with your surgeon to see what he/she recommends.  

I have corrected "bottoming out" with the use of dermis for many patients... sometimes we are able to go larger in size and still have stable results  (it depends on that patient''s specific situation) but a bigger implant will put more pressure on any repair that is performed.  

San Diego Plastic Surgeon
5.0 out of 5 stars 1,486 reviews

Bottoming out after augmentation

Adjusting the fold is not an uncommon need.  Strattice is only one of many products useful for this, but it is possible to adjust folds up or down without the need for extra material.  Since these products are expensive I rarely use them for cosmetic breast enhancement, even when adjusting for a effaced (bottomed out) fold. Having said that, if you are having more surgery for symmetry, you should not have any hesitation about changing implant size.  Bigger implants, though, can make it harder to raise a fold. This is a very surgeon-specific thing.

Daniel Greenwald, MD
Tampa Plastic Surgeon
5.0 out of 5 stars 44 reviews

Revision may work if the problem is due to the pocket

It does not make sense to go bigger if implant has bottomed out after revision. Bigger implant with stress the pocket revision and it will fail.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
4.8 out of 5 stars 122 reviews

Reoperation for bottoming out after previous Strattice placement

Assuming that the piece of Strattice was of adequate size to correct the first bottoming out, I feel that your implants might be too big already (guessing since you did not post any photos) or your tissues are too thin and inelastic to support an implant. I would certainly not recommend larger implants, based on what you describe. You need to discuss the surgical plan with your plastic surgeon and find out what is the reason the previous corrective surgery failed. Good luck.

George Marosan, MD
Bellevue Plastic Surgeon
4.8 out of 5 stars 38 reviews

At some point breast implants won't work well for you

Unfortunately there are a small number of patients for whom breast implants just won't work.  You have obviously had at least a primary augmentation and a major revision with Strattice and now are describing new problems and that fact that you don't love the result anyway.  

For a variety of reasons related to the nature of your tissues, the choices made, and some technical surgical considerations it just might be that it would be best to leave it alone or to have the implants removed.  Continuing to revise them becomes progressively less likely to give you a great result.  Before proceeding I would visit a few other surgeons in your area and ask them honestly if this can be made better or best left alone.  Good luck with this tough problem.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 67 reviews

Reoperation after Strattice for breast implant change

There should be no problem with re-operation on the breast after Strattice has been placed. However, I do not know any of the specifics of your case, and your own surgeon is in the best position to make a recommendation. Larger implants because they are heavier could contribute to making the bottoming out issue worse.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 52 reviews

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