What are options for a repeat augmentation repair with current strattus placement and stretching causing implant dropping.

Your tissue may still be too thin to support much weight. You may need to go even smaller and consider a muscle or capsular flap for support. Please discuss this with your surgeon or see one who does a lot of revisions for bottoming out from heavy implants.

There are other types of mesh to consider using, but I think one of the major considerations to make is breast implant size. If you do go forward with revision surgery, choosing a breast implant that is small enough be held up by your weakened tissue is going to be important. Other types of mesh in the market can be used as well to help resist this bottoming out/dropping of the implant, but they are not perfect.
Your pain is going to be a tough thing to make a recommendation on without an in person consultation. There could be many reasons for this, the majority of which may not be helped with surgery.

Hello !

Strattice is utilized in breast augmentation revision for two purposes. Firstly, it helps to manage the size and placement of the implant, particularly in situations like 'bottoming out'. Secondly, it can potentially reduce the likelihood of capsular contracture recurrence. It's essential to ensure that the implant is positioned in the pocket appropriately and centered within the breast, with Strattice support if necessary, so that it doesn't need to 'drop' after the revision. If you experience any discomfort or concerns, it's advisable to seek advice from your surgeon.

Best of luck !