Internal suture (not galaflex) - will this offer more projection and prevent bottoming out?

If you are bottoming out, I don't suggest going larger for this will stretch and thin your tissue more and be less supporting. Internal sutures often work. Galaflex is more insurance to help prevent bottoming out for many women. You did not post photos, which would have been very helpful. don't chose an implant that is too large and heavy for your frame and tissue.

Dear Vivid233724,
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 am one of the only two surgeons in the Los Angeles area who are surgeon investigators for the Motiva FDA approval trial, which began enrollment in 2018. The surgeon you are seeing was not, and has little or no experience, hence her erroneous statement about Motiva implants dropping more than smooth implants. Although this was a concern among European surgeon's who spoke to us prior to the study, their concerns were unfounded. Motiva nanotextured implants displace no more frequently than smooth walled implants, and have the benefit of a lower overall and long term risk of capsular contracture. I would continue with Motiva and select the appropriate size and profile, and perform a capsulorrhaphy with mesh.