I have tubular, sagging breasts - should I consider mesh in addition to my implants if PHASLX ST is my only option?

Unfortunately, you have not provided photographs or told us your bra size. However, the technique I recommend is The Bellesoma Method. This will reshape your breast tissue creating upper pole fullness without implants, elevate them 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. Later, fat transfers can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Dear Thriving462160,
tuberous breasts are not simply small or underdeveloped breasts. The appearance of the breast can range from mild to severe, and typical traits include: enlarged, puffy areola, rather wide spacing between the breasts, very little breast tissue, sagging, higher than normal inferior breast fold, and narrow base at the chest wall.The type of surgery best for you will depend on the severity of your condition.My preferred technique for tuberous breast correction involves a multistep procedure where the breast tissue is released in a radial pattern to prevent herniation into the areola and placement of a custom implant size is in the breast to allow appropriate expansion of the breast in the restricted dimensions. This can often be done in a single procedure but sometimes may require two surgeries.That said, it is best that you visit a board-certified plastic surgeon for an in person examination. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

I understand your surgeon’s desire for re-inforcement, but in my experience the only patients who need mesh support are individuals who have had mastectomy, where all breast tissue has been removed. If you do have some native breast tissue present, you have a good shot of having a nice results without mesh support. With current implants such as Sientra HSC+ or Natrelle Soft touch, there is little chance of rippling due to their highly cohesive nature. In the past, submuscular placement was preferred due to the loose, ripple prone nature of the old style implants. That challenge has been surmounted with the advent of the gummy bear implants..

You did not post photos, so I cannot be specific. Most women who think they have "tubular" breasts only have sagging breasts instead. Since I have not examined you and your surgeon has, I will refer you back to your surgeon.

Without seeing pictures, we can’t begin to make an assessment.
Did your surgeon show you lots of before and after pictures of previous patients who had similar breast characteristics who had the same operation?
Consider having multiple consultations before selecting a provider.
Bring pictures of yourself taking the same way plastic surgeons take before and after pictures.
Use these pictures as reference during the consultation.
During each consultation, ask each provider to open up their portfolio and show you their entire collection of before, and after pictures of previous patients who had similar body characteristics who had the same procedure, the surgeon is recommending.Take careful notes during each consultation, especially regarding the quality and quantity of before and after pictures shown.
There’s no correct number of consultations needed to find the right provider.
The more consultations you scheduled the more likely you are to find the better provider for your needs.
There is no right or wrong answer to your question.
It all depends on what is indicated which is based on what you look like in combination with each providers skill and experience.
When in doubt, slow down and schedule more consultations.
I generally recommend patients avoid virtual consultations and always rely on in person consultations whenever possible.
Best,
Mats Hagstrom MD