Should I get galaflex for low pole support in primary subfascial breast implants? (Photos)

Question

I have had at least 6 consultations with different surgeons. I now am between two, however one wants to use a galaflex mesh “internal bra” and the other says that’s unnecessary. I am very worried about sagging in the long run, as the lack of sagging is one of the only thinks I really like about my small breasts. I have done a ton of research; and have come out the other end more confused. Is the mesh worth the possible additional complications? With two equally qualified surgeons telling me two different things, I don’t know how to decide.

Brian K. Reedy, MD · Answer

Thanks for your question! There isn't one right or wrong way to do things, and I'm sure they both have their reasons for why or why they didn't recommend Galaflex. You appear to have a well-developed inframammary fold, so I'm not sure I think it's necessary. At the end of the day, go with your gut. Best of luck!

Mert Demirel, MD · Answer

For a first-time breast augmentation in someone with small breasts and no significant sagging, GalaFLEX is not always necessary. A well-sized implant, careful pocket creation, and good surgical technique are usually the most important factors for long-term support.
GalaFLEX can be useful in selected patients, especially when there is weak tissue, recurrent bottoming out, revision surgery, significant laxity, or a high risk of implant descent. It acts as a temporary internal scaffold while your own tissue strengthens around it.
However, it also adds cost, operative time, and potential risks such as inflammation, palpability, infection, seroma, or the need for future surgery. It should not be used only because of fear of sagging if your anatomy does not clearly need it.
If your breasts are small, tight, and not sagging now, the best way to reduce future sagging is often to choose a conservative implant size that fits your breast base and tissue strength. Very large implants create more long-term stretch, with or without mesh.
My advice would be to ask both surgeons why they recommend their plan in your specific anatomy. If the surgeon recommending mesh can clearly explain a tissue-support problem, it may be reasonable. If the implant size is modest and your tissues are strong, it may be unnecessary.

Ted Eisenberg, DO, FACOS, FAACS · Answer

No mesh. In my experience, the only two things that could possibly change your result of surgery after complete healing would be, significant weight change (~10%) or the possible stretching of the breast tissue from the milk of pregnancy. The mesh doesn't stop either of those possible changes. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Gerald Minniti, MD, FACS · Answer

Unfortunately, sometimes surgeons say things that aren't correct. There is abundant data published in high quality, peer reviewed journals showing the safety and efficacy of resorbable mesh. Busy breast surgeons like myself use mesh in almost all cases, both primary and revision (The only time I don't is when I'm doing a Preserve breast augmentation, a technique that preserves circum-mammary ligaments that nest the implant under your breasts.) Other than Preserve, subfascial breast augmentation is in my opinion, the best of all standard options for implant placement, however. The only real issue is sufficient soft tissue coverage in the upper pole of the breast, and when Motiva implants are used, 1.5 to 2 cm is sufficient.

John LoMonaco, MD, FACS · Answer

Short answer is no.  Its a foreighn material and while it does absorb, there have been complications.  I reserve it for women with loose skin, those who have damaged skin from massive weight gain/loss, or alongside a breast lift to support the lift.

In your body type, proper technique and careful implant selection are the most important things to address if tyou want to avoid sagging.  Placing an impant that is beyond the capability of your skin to hold is in my opinion the most common reason for early sagging or poor implant position long-term.

Laura Roider, MD · Answer

@Plucky887365 thank you for the question and including photos for review. It allows for custom recommendations. 
I frequently get asked about mesh vs no mesh in a primary augmentation and you're right to wonder why some surgeons recommend it and some don't! I primarily perform subfascial augmentations and will recommend mesh for patients who select an implant over 250cc. 
While this is a slightly arbitrary cutoff, the benefit of mesh is the long term support for heavier implants.

Yasemin Aydinli, MD · Answer

Both surgeons can be right &mdash; this is a judgment call, not a right/wrong question. In primary augmentation with good tissue quality, moderate implant size, and no existing sagging, mesh support is rarely necessary; the strongest predictors of long-term sagging are implant weight, tissue elasticity, and skin quality. Galaflex shows its clearest benefit in revision cases, significant ptosis, or very weak tissue. If your implants will be modest in size and your tissue is firm, the simpler operation without added device material is a very reasonable choice &mdash; choosing a conservative implant size protects you from sagging more than any mesh does.

Camille Cash, MD · Answer

It's not unusual to have differing opinions when visiting different surgeons.  There are several factors that are related to breasts sagging.  Some include weight fluctuations, pregnancy, breastfeeding, skin elasticity and genetics.  The size/weight of the implant that you choose along with implant position can influence sagging in the long run.  Without knowing more about these factors and the implant you are considering it's difficult to give a recommendation.  Perhaps the reasoning with each surgeon so you can better understand their position.

Should I get galaflex for low pole support in primary subfascial breast implants? (Photos)

Answers (8)

More Breast Implants Questions

What is the risk of reinfection if I get new implants 6 moths after treatment of cellulitis?

I want to replace volume with a natural slope - Pseudoptosis? Lift or no lift? (Photos)

How would a person know if they had silicone implants and there was a leak and and what would be the danger if there was a leak?

Nipples leaking fluid 9 years post breast augmentation - what should I do? (Photos)

470 vs 600 vs 750cc on a tall, broad trans woman's frame — how do I stay natural but proportional? (Photos)

5'9", 100 kg, trans woman - Is a 600cc moderate plus implant the right choice for my frame?

WE SEND PRETTY
EMAILS