Strattice for Revision of Capsular Contracture and Bottoming Out (photo)

Originaly BA was 01/2012 with Mentor Smooth Round HP 500cc(R) and 450cc(L). Obviously this is not the result I was looking for. I am currently researching revision to correct the capsular contrature on the right and bottoming out on the left. Considering the complications I have had with the 1st surgery is it wise to consider revision through internal sutures alone or is a product such as Strattice my best bet to avoid further capsular contracture and bottoming out? Help! Thank you!

Doctor Answers 6

Treatment of Capsular Contracture with Strattice.

Capsular Contracture and Bottoming out are both uncommon problems but can occur after a breast augmentation.

Capsular Contracture can cause hardening of the breast, distortion or pain in severe cases. This occurs because of the scar tissue that forms around the implant squeezing it cause the implant to shift and feel more firm to touch.

Bottoming out is more common with saline implants than with silicone implants but can happen with either one. The implant shifts down below the natural fold of the breast and leads to the deformity.
Strattice is a dermal mesh that can be used for multiple purposes in breast surgery. The Strattice is used in capsular contracture in an attempt to prevent the scar tissue from forming completely around the implant. The mesh covers part of the implant and prevents the scar tissue from completely surrounding the implant and thus the scar tissue can not squeeze the implant in the same way.

In bottoming out the scar tissue around the implant was not strong enough to hold the implant in place. The Strattice is used to enhance the strength of the fold to hold the implant in the proper position. It reinforces the repair that is done internally to reposition the implant.

Austin Plastic Surgeon
4.9 out of 5 stars 123 reviews

Strattice for Revision of Capsular Contracture and Bottoming Out (photo)

I would agree that Strattice is very effective in the treatment of capsular contracture. In fact, it is arguably the best treatment we have for it.

My guess is that it will not be easy to obtain a symmetric result for you. If it were me, I would treat your right breast first, with an open capsulectomy and implant exchange along with Strattice. The way things look in the operating room immediately is not what things will look like 2-3 months down the line. I would let things settle and then address the left breast (if necessary) at that time.

Paul H. Rhee, MD, FACS
Castle Rock Plastic Surgeon
5.0 out of 5 stars 28 reviews

Strattice for bottoming out and capsular contracture

Strattice is very effective at preventing recurrent capsular contracture, which is otherwise high using the usual techniques including plane change (for example over to under the muscle), capsulectomy (removal of the scar capsule), and implant exchange. It also re-creates support and coverage for the implant after the capsulectomy, which thins the tissue around the implants. Strattice is also effective at supporting implants that have dropped. If you can feel the implant through the skin along the bottom, then you may wish to consider Strattice on that side too.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 53 reviews

Capsular contracture and bottoming out

You dont give details as to implant position and degree if any of hardness of the right breast

It appears to me that you either have submuscular implants with a high riding implant on the right,caused my muscle elevation, and bottoming out on the left as a result of the implant slipping below the muscle ,or you have subglandular implants with capsular contracture on the right and ptosis on the left due to subglandular placement and poor tissue support

These are all common occurrences with breast augmentation surgery

In either case conversion to a subfacfial pocket would be my procedure of choice to correct both problems

you would need to see an experienced board certified surgeon to evaluate your situation

and advise you

Hilton Becker, MD
Boca Raton Plastic Surgeon
4.6 out of 5 stars 15 reviews

Breast Augmentation Revisionary Surgery Options?

Thank you for the question and pictures.

I'm sorry to hear/see the complications you have experienced after breast augmentation surgery. Certainly revision breast surgery will be helpful to you. In regards to the exact details of which procedure will best meet your goals and prevent further complications, it will be best for you to meet with well experienced board-certified plastic surgeons who can demonstrate significant experience helping patients and your situation. I think you will find that it is plastic surgeon experience and attention to detail,  not the use of Stratiice ( or not)  that will make the most difference in your outcome.

I hope this and the attached link helps.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,499 reviews

Complications following breast augmentation

Thank you for your questions and pictures. Regarding the right breast I recommend doing capsulectomy without Strattice. Starttice  is recommended for patients who have recurrent capsular contracture. As for the left breast, you had inferior and some lateral malposition of the implant. For that internal suturing would help in reshaping the breast. Ultimately, the type of surgery will be determined after examination of the breasts. 

Moneer Jaibaji, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 15 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.