Is the tissue strattice matrix the best option? Need second opinion because it is expensive.

My saline implant has rippled (bad) my left breast is now very saggy. When I lay down they fall into the armpit and shows two gaping holes in my chest, the left breast also cripples up. I went to a specialist today and he suggested that I get silicon implants, with the matrix, and I will need to do a lift on the left side, and also make the nipples smaller since they have stretched so much. He quoted me $15,000 which is why I am asking. I had tubular breast deformity when this started, I'm 25.

Doctor Answers 5

Is the tissue strattice matrix the best option? Need second opinion because it is expensive.

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Obviously without examining you this is somewhat difficult to answer.  I use Strattice often in my practice when repairing a bottomed out implant or helping with rippling.  There is another product called Seri that I also use since it is somewhat cheaper and a good product. You may want to ask your surgeon about this option. Good Luck!

Strattice not required

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Tubular breasts are one of the most difficult deformities to correct. The technique I recommend is Implant Exchange with Mini Ultimate Breast LiftTM. Using only a circumareola incision it is possible to reshape your breast tissue creating upper pole fullness, elevate them higher on the chest wall and more medial to increase your cleavage. At the same time, your implants can be exchanged for new ones. Aligning the areola, breast tissue and implant over the bony prominence of the chest wall maximizes anterior projection with a minimal size implant. Small round textured silicone gel implants placed retro-pectoral look and feel more natural, are more stable, less likely to ripple or have complications needing revision. Implant profile is irrelevant in the retro-pectoral position since the muscle compresses it. You are an excellent candidate for this technique to revise your previous result. Saline implants ripple more and should be replaced with silicone. This technique will decrease the gap between your breasts when you lie down and elevate them higher on the chest wall. The cost of this procedure is $11,500. Your excess skin is used to make an internal support bra and strattice is not required.

Best Wishes,

Gary Horndeski, M.D.

Acellular Dermal Matrix and Revision

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Sounds like you have a complex problem that is even harder to asses without photographs.  I would say your PS is probably giving you good advice but I would seek a few other opinions. We all do things differently and the more opinions you get the better your understanding will be of the issues and the more likely you are to choose the right surgeon for the right price.

Strattice for the correction of implant pockets that are too large

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It would be helpful to see pictures, but from your description it sounds like your surgeon is on the right path.  Silcone gel implants are artistically superior to saline implants are are less prone to rippling.  For complex revisional breast surgery I have found materials such as strattice extremely helpful to reduce the size of the pocket and maintain proper dimensions.  Very often patients who seek revisional surgery have weak tissue structure, and the simple use of stitches to control the pocket shape doesn't work very well.  Materials such as strattice are expensive, but yet another surgery is even more expensive.  Best of luck!

How to treat rippling

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Rippling is one of the most distressing of all postoperative complications.Three factors contribute to it: the type of implant, the thickness of the tissue coverage, and the tightness of the skin envelope.

Saline typically ripples more than silicone, but if a saline implant was "overfilled" it may actually ripple less than saline.  Textured implants tend to ripple more than smooth, but there are several type of silicone implants that ripple less than the smooth implants, namely any of the textured anatomic high cohesive implants, particularly the one made by allergan (because it is the firmest.)  The textured round by Sientra also has a low degree of rippling.

Tissue coverage is the most important thing that predisposes to rippling.  Thin patients nearly always ripple to some degree, and patients with thick breast tissue never ripple.  The point of Strattice is to thicken the tissue coverage.  Are you already behind the muscle?  Because if not, just going behind the muscle and switching to silicone will make some difference, perhaps enough given the situation.  But if you are already behind and have a rippling problem, then Strattice™ may be critical.  Fat injections can also help, but frequently patients who ripple do not have donor fat.  Strattice™ is wonderful, but it is not a cure-all.

Droopiness also contributes to rippling.  When the envelope is under filled with the implant, then the implant will tend to ripple.  Tightening a loose envelope can go a long way to helping to reduce rippling.

RIppling is actually a complex problem.  No one who has not evaluated you in person should offer you specific advice.  You need to ask around and find someone in your area with real experience in this.

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.