Strattice for Breast Augmentation Revision to Prevent Movement into Armpits

Strattice for Breast Augmentation Revision -- to use or not to use -- is that the question?

Other surgeons here have given varying opinions about using a material such as Strattice. The reality is that there is not a single answer. While purported benefits of using Strattice include situations such as yours (thin tissues and need for additional reinforcement of the implant pocket), it really comes down to an assessment of your own tissues to determine what we are working with.

Your surgeon has made a recommendation to use Strattice and to downsize your implants. This sounds reasonable. And without being able to examine you, I wouldn't be able to make a different recommendation.

While your are quite thin, I have had other thin patients that have had great success with revising an implant pocket without the use of Strattice, particularly when using a silicone implant. I also feel that using silicone gel implants and downsizing both weigh a bit against using Strattice.

Hope this helps,

Nick Slenkovich, MD FACS

 

 

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.

 

Without personally examining you and discussing your goals, no one can give you definitive advice. It sounds like you are thin and the implants are large for your size, which can lead to stretching and thinning of the tissues around the implant and loss of support. If this is the case then the tissues would need to be reinforced and Strattice is a very good way to do that. On the other hand, if an revision is attempted and it fails, that can lead to even more thinning and a worse problem, not to mention spending more money in the long run than the cost of Strattice.

It sounds like you will need an internal capsulorrhaphy to close down the lateral breast pocket.  In my opinion, Strattice would be a useful adjunct for a more reliable revision.