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

Question

HiI did a breast augmentation surgery 6 months ago but the implant size is too small (motiva 355cc) with barely no projection. dropped significantly and it bottomed down. My surgeon said we can do a revision where she will use mentor implant higher projection because motiva temds to go down more She said she will do internal suture below the breast and on the side to hold the breasts more. Will that work? Will she make bigger incesion to do the side sutures? Will it hurt?

Daniel Barrett, MD · Answer

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

Gerald Minniti, MD, FACS · Answer

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.

Gary M. Horndeski, MD · Answer

Sutures can be used to reposition the size of the capsule to pull the implant more medial and higher.  However, sutures can fail as well.  Also, the weight of the implant may be a factor in determining failure of the repair.  It is possible to replace the implant in a different pocket with a higher and more medial position.  You may also consider a lift.

Best Wishes,

Gary Horndeski, M.D.

Connie Hiers, MD, FACS · Answer

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.

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

Answers (4)

Answer: Surgery

Answer: Surgery

Recommended reading

Everything you need to know about Breast Implant Revision

Our mission is to create a world where every investment in modern beauty is Worth It.

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

Answers (4)

Answer: Surgery

Answer: Surgery

Browse related questions

Recommended reading

Everything you need to know about Breast Implant Revision

Our mission is to create a world where every investment in modern beauty is Worth It.