Strattice for Breast Augmentation Revision to Prevent Movement into Armpits

I am sorry about the complication you have experienced. Most patients who undergo this type of revisionary breast surgery benefit from capsulorraphy (internal suture repair). This procedure serves to reconstruct the lower poles of the breasts and prevent migration of the breast implants too far inferiorly. Associated issues with positioning of nipple/areola complexes should improve with this operation. In my practice, I use a 2 layered suture repair, supporting the involved area. I do not find the use of acellular dermal matrix or mesh necessary for the majority of patients who present with breast implant displacement problems. Factors such as recurrence of breast implant displacement/malposition and the presence of poor quality skin/tissue support come into play when making a decision to recommend/utilize additional support materials.Generally speaking, the use of acellular dermal matrix or bio synthetic mesh for patients in your situation may be helpful occasionally. This material may be helpful as a supportive matrix and help with the breast implant displacement/malposition you are experiencing. Again, I usually recommend their use depending on the patient's anatomy ( for example quality/elasticity of the involved skin) and past surgical history.You may find the attached link, dedicated to revisionary breast surgery (demonstrating many cases of corrective surgery for patients with "bottoming out" of breast implants) helpful to you as you learn more. You will find a separate page, on the same website, dedicated to lateral displacement situations specifically.Best wishes.

Hello! Thank you for your question!  Given your history and symmetry and shape issues, consideration for either an acellular dermal matrix or mesh-type substitute is reasonable.  A capsulorrhaphy would be needed for revision of your breast pocket. If you do need such, the use of a dermal matrix or mesh may be considered if your tissue now has significant laxity that is failing in support or a significant deformity in which recreation of the breast pocket is required along with adding additional support and coverage of the implant.  Certainly, the larger the implant, the heavier the weight...thus, it may be useful to consider placement of a matrix or mesh. Otherwise, capsulorrhaphy for pocket revision using your native tissue should suffice.  It has been used safely and effectively to correct synmastia, restore the inframammary fold, mask implant issues (e.g., rippling, wrinkling, etc.), and improve aesthetic results in revisionary breast implant and reconstructive procedures.  However, only by physical examination would one be able to make recommendations on the benefits over the risk of using a matrix or mesh in your situation. Consult with a plastic surgeon well-versed in breast procedures and the use of dermal matrices and mesh in breast procedures who will assist you in determining which procedure(s) would be the best for you.

Avoid Stratice! Your own body has a much better structure: Fascia intelligent use of the subfascial plane is the 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.