How safe is the use of mesh in revision surgery?

It is incredibly safe if done with proper technique by a well-trained plastic surgeon. I recommend seeing a board-certified plastic surgeon (American Board of Plastic Surgery). Ideally, this surgeon has also completed an accredited aesthetic fellowship (The Aesthetic Society).

Dear GetGab,
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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

I recommend explantation and lift using The Bellesoma Method. The implants are removed, your breast tissue is reshaped creating upper pole fullness, elevated higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained if not injured during your previous surgery. Later, fat transfers can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Thank you for your question. A large portion of my practice is dedicated to breast surgery and revision breast surgery. I have been in practice for over 28 years. In your case, you would benefit from an internal bra procedure - capsulorrhaphy. I wrote the very first paper on capsulorrhaphy over 20 years ago. If you are on top of the muscle, then I would reposition the implants under the muscle. I wrote that paper too. I rarely use mesh or feel that is needed in most cases. I find that many surgeons are not skilled at these procedures and have high rate of recurrence. You should be able to have an excellent result. Best wishes to you

The question is whether mesh is dangerous.

There are lots of different “mesh“ options. In breast surgery, especially aesthetic breast surgery, most mesh used today is dissolving much like suture material.

While it does probably increase the risks of surgery with regard to infection and the ability to temporarily feel the mesh, it is generally safe to use and can make quite a difference, preventing stretch of Tissues while healing.

I find it particularly valuable in supporting tissues with breast lifting Along with augment, and repairing an Over expanded pocket. It is not Absolutely necessary, but I personally believe it improves the long-term results.

Most problems related to breast augmentation, and lifting are related to an oversized implant, Or substantial tissue damage from weight gain, weight loss cycles.

If your surgeon is experienced and board-certified, my inclination is to trust them. Second opinions can be valuable, however.

The mesh normally used is actually replaced by your own tissue over an 18-month time span. There is also permanent mesh, but this is used more for hernia repairs.

There are many types of "mesh" out there and some are more difficult to remove than others. At this time many of us are using Galaflex (i like the lite version). Its absorbable and very easy to remove if needed.

Correcting implants that have bottom out is a fairly complex and moderately difficult procedure to do well in regards to having quality long-term outcomes.
The procedure can be done using permanent suture with or without mesh or cadaver dermal products like Alloderm.
By far, the most important variable is provider selection.
If you’re working with the same surgeon, who did your augmentation, then you may want to consider getting some second opinions implants that is a direct reflection of poor surgical technique and in some cases, poor selection of implant size.
The repair with either mesh or cadaver dermal products tends to be more reliable than using permanent sutures alone.
Each provider will have their own view on how this is best done.
As always, the case provider section is the most important variable.
Considering the complexity of this procedure, patient should always confirm that the provider has done this procedure successfully numerous times before and con demonstrate that by showing you lots and lots of before, and after pictures of long-term quality outcomes previous patients.
If you’re looking for a provider, then look for plastic surgeons who have the most extensive backgrounds in breast surgery.
Consider plastic surgeons in your community who do of the breast cancer reconstruction in your area.
Plastic surgeons who do a lot of breast cancer reconstruction tend to be good at complex breast surgery.
Finding the right provider usually requires multiple consultations.
During each consultation, bring pictures of your own breasts and ask providers to open up their portfolio and show you their entire collection of before, and after pictures of previous patients who had similar characteristics to your own.
The most experienced providers should have the biggest collections of before and after pictures.
Best,
Mats Hagstrom MD