Strattice Worth $3,000 for Recurrent Capsular Contracture

Question

I had a ba in 2001 with smooth, saline, over the muscle and developed bilateral cc, worse on right side, within a few months. In 2003 I went to a new ps, I changed to a smaller implants, smooth saline, under the muscle, ps used drains, and I developed cc again in the right side with in a few weeks. In 2005 I removed the implants. I have been reading about the use of strattice for recurrent cc. I was quoted $3K for the strattice. What kind of results have you had with using strattice for cc?

Rian A. Maercks, MD · Answer

Avoid Stratice! Your own body has a much better structure: Fascia intelligent use of the subfascial plane is the answer

	 

	 

	 

	The problems that lead to suggested use of Stratice and dermal fillers are way too common.  The reality of breast augmentation is that most women have similar results and are simply not aware that there is a better option.  The most commonlyt used technique is the  "dual-plane" subpectoral placement.  this sets up the implants for lateral and inferior malposition.  The top of the breast has muscular coverage and because of the pectoralis major's origination next to the sternum, the implants are pushed away from midline creating the valley between them that you dislike ( I call this the Miami Valley based on the common augmented look of breast augmentations in Miami).  Because the inferior portion of the breast is subglandular,  there is no support and the implant tend to migrate toward the armpits then down.

	 

	For these reasons I do not perform submuscular or dual-plane breast augmentations.  I use a technique that I call "Cold-Subfascial Breast AugmentationTM" that overcomes the shortcomings of dual plane.  By leaving the muscle alone and precisely lifting the strong pectoralis fascia,  I am able to custom design what is essentially a living natural brassiere to support the implant within the breast.  Using this technique I am able to create beautiful natural appearing breasts that complement the individual patient's body.

	 

	I commonly revise patients in your position by converting them to the cold-subfascial plane.  In my experience this is the only way to repair the breast and create a long-lived beautiful result.  Artificial materials such as stratice are just asking for trouble in my opinion.  I hope this helps!

	 

	 

	All the best,

	 

	Rian A. Maercks M.D.

Bradley Bengtson, MD, FACS · Answer

The answer is ... Absolutely!I have over 250 patients and although the complication rate with the use of these ADM's is not zero, I have yet to have a capsular contracture when all of the prior scar is removed and a large enough sheet of Strattice is placed 7-8 cm high extending down from your pectoralis muscle covering the implant.You need to see a plastic surgeon who has a great deal of experience in breast revision surgery and with these materials but the results are very good and consistent when used properly by experienced surgeons.All my Best!Dr B

Raffy Karamanoukian, MD, FACS · Answer

Our office specializes in breast augmentation revision and capsular contracture cannot be eliminated with strattice alone.  We use a combination protocol including surgery, capsulectomy, postoperative massage, and oral medicines to decrease the risk of recurrence. Dr. Karamanoukian

Richard Baxter, MD · Answer

I have used Strattice a few times for recurrent capsular contracture, and it has been effective with more than a year follow-up. Since your contracture recurred early, i think it is a very good idea. It is unfortunately quite expensive but it is a unique product.

Aaron Stone, MD · Answer

All breast implants develop capsules shortly after they are placed. The question is what type of capsule will it be. That cannot be predicted before your body makes it. The capsules can be paper thin, a centimeter or two thick, contain muscle contracting like cells etc. Although Alloderm or other acellular dermal matrixes(ADM) may prevent the formation of bad contracting capsules I cannot logically see why that would be the case and to my knowledge that is have never been proven. ADMs are mostly used to reconstructed inframammary folds, treat symmastia or increase tissue coverage to hide rippling.

Otto Joseph Placik, MD · Answer

Recurrent capsular contracture treatment with acellular dermal matrix is confusing due to the proliferation of biologic materials available. For example, some insist that Alloderm is superior to Strattice. You may want to skip the implants altogether and consider fat grafting for smaller sized augmentations in th erange of 250cc.

Gregory A. Buford, MD, FACS · Answer

Recurrent capsular contracture can be a very troublesome issue, as you have found out.  When this happens, many Plastic Surgeons (such as myself) will change out the implants (to address a possible bio-film), and then place a sheet of acellular dermal matrix such as Strattice between the implant and the scar capsule, and revising the capsule itself.

	While there are certainly no guarantees with this approach, most of us do find that our success rates may improve over simply changing out implants. 

	I hope that helps!

Paul Gill, MD · Answer

Recents studies show a trend towards reduced rates of capsular contracture with the use of alloderm. Similar thought process has been applied to strattice. If you are considering replacement of your implants for elective cosmetic reasons, I would strongly consider the risk of recurrent contracture. If you desire to proceed with re-augmentation, it is important to understand that there is no proven method to prevent recurrent contracture and further complications.

Steven Wallach, MD · Answer

Yes, products like strattice or Alloderm seem to reduce the rate of capsules at least early on in the research, bu tno long term data is available yet.

Darryl J. Blinski, MD · Answer

Great question hard to answer. In Boca Dr Jason Posner is the PS wirth the most experience. Call him. From MIAMI Dr. Darryl j. Blinski

Strattice Worth $3,000 for Recurrent Capsular Contracture

Answers (12)