I am having a revision done for bottoming out and I would like to know which of these materials is superior. My concerns are both the increased risk of developing capsular contracture after a revision surgery and the bottoming out. I know Strattice assists with both of those. Does Galaflex?
Answer: Bottoming our repair with mesh: when, why and which one? Bottoming out is often due to thinning and loss of implant support and coverage. In that situation, the capsule is not strong enough to support repair with capsulorrhaphy regardless of which sutures are used and how long you wear a bra. Adding support with ADM such as Strattice or mesh such as Galaflex creates an internal bra. The data is better for prevention of capsular contracture with ADM's but Galaflex should also work well for correction of bottoming out.
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Answer: Bottoming our repair with mesh: when, why and which one? Bottoming out is often due to thinning and loss of implant support and coverage. In that situation, the capsule is not strong enough to support repair with capsulorrhaphy regardless of which sutures are used and how long you wear a bra. Adding support with ADM such as Strattice or mesh such as Galaflex creates an internal bra. The data is better for prevention of capsular contracture with ADM's but Galaflex should also work well for correction of bottoming out.
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November 15, 2019
Answer: Explant and active lift using The Bellesoma Method Unfortunately, you have not provided photographs or told us your bra size. However, if you are having problems with your implants, an alternative to consider is 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. Galaflex and Strattice provided only passive support. The Bellesoma Method transfers the weight of the breast to the underlying pectoralis major muscle and provide active lift. Best Wishes,Gary Horndeski, M.D.
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November 15, 2019
Answer: Explant and active lift using The Bellesoma Method Unfortunately, you have not provided photographs or told us your bra size. However, if you are having problems with your implants, an alternative to consider is 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. Galaflex and Strattice provided only passive support. The Bellesoma Method transfers the weight of the breast to the underlying pectoralis major muscle and provide active lift. Best Wishes,Gary Horndeski, M.D.
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November 15, 2019
Answer: ADM’s do serve a purpose but... Thank you for your question and Generally I do agree with Dr. Widder in that I think a really good capsulorrhaphy and even more importantly support for 6 to 8 weeks (I actually do it longer!) can solve the majority of bottoming out problems. I too do a lot of revisions, and there are some women who simply need ADM… They just have way too thin of tissue and lack of support. I have also used Strattice in cases of persistent capsular contraction, which it seems to reduce. I do not have any experience with Galaform and capsular contracture. So for a first time bottoming out situation I almost always go to capsulorrhaphy as my first option…
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November 15, 2019
Answer: ADM’s do serve a purpose but... Thank you for your question and Generally I do agree with Dr. Widder in that I think a really good capsulorrhaphy and even more importantly support for 6 to 8 weeks (I actually do it longer!) can solve the majority of bottoming out problems. I too do a lot of revisions, and there are some women who simply need ADM… They just have way too thin of tissue and lack of support. I have also used Strattice in cases of persistent capsular contraction, which it seems to reduce. I do not have any experience with Galaform and capsular contracture. So for a first time bottoming out situation I almost always go to capsulorrhaphy as my first option…
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March 5, 2021
Answer: Redo breasts augmentation Dear Thoughtful, Posting your pictures would have been helpful. I have been in practice for over 32 year and performed breasts augmentations and redo breasts augmentations on thousands of patients, including many bottoming out breasts. I have never used Strattice or Galaflex, because it is unnecessary. As a matter of fact, I operated on few patients who got Strattice by other surgeons and I had to remove ,at least, part of the material because of irregularities. Bottoming out requires inferior capsulorrhaphy ( internal bra ) , which means excision of a sleeve of capsule at the sub mammary crease and suturing of the edges of the capsule with multiple permanent sutures , creating a higher level crease. After surgery you will have to wear a bra with a wire 24/7 for 6-8 weeks, to allow a strong scar to form at the crease. This technique worked for me very well without need for Strattice or Galaflex. Always, consult with experienced board certified plastic surgeons who operate in accredited surgery center for your safety. Most importantly, check the before and after pictures of redo breasts augmentation in the photo gallery, to make sure that they are numerous, consistent and attractive with nice cleavage, perky, symmetrical and natural looking. Best of luck, Dr Widder
Helpful 1 person found this helpful
March 5, 2021
Answer: Redo breasts augmentation Dear Thoughtful, Posting your pictures would have been helpful. I have been in practice for over 32 year and performed breasts augmentations and redo breasts augmentations on thousands of patients, including many bottoming out breasts. I have never used Strattice or Galaflex, because it is unnecessary. As a matter of fact, I operated on few patients who got Strattice by other surgeons and I had to remove ,at least, part of the material because of irregularities. Bottoming out requires inferior capsulorrhaphy ( internal bra ) , which means excision of a sleeve of capsule at the sub mammary crease and suturing of the edges of the capsule with multiple permanent sutures , creating a higher level crease. After surgery you will have to wear a bra with a wire 24/7 for 6-8 weeks, to allow a strong scar to form at the crease. This technique worked for me very well without need for Strattice or Galaflex. Always, consult with experienced board certified plastic surgeons who operate in accredited surgery center for your safety. Most importantly, check the before and after pictures of redo breasts augmentation in the photo gallery, to make sure that they are numerous, consistent and attractive with nice cleavage, perky, symmetrical and natural looking. Best of luck, Dr Widder
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November 15, 2019
Answer: Bottoming out Dear Thoughtful2810,
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November 15, 2019
Answer: Bottoming out Dear Thoughtful2810,
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