This website has been so helpful to me during my BA journey. I wanted to also share my experience and give back to the community. I had my primary breast augmentation done a while ago. Though I went to one of the best doctors available in the country I was working in at the time (Seoul, South Korea, the Land of Plastic Surgery lol) - I experienced bottoming out and lateral displacement shortly after surgery. At the time we didn't know what happened, if it was from me healing poorly or from surgeon error. I was told to keep wearing my surgical bra 24/7 for 3 months to prevent it from getting worse. It helped at first, but unfortunately it got worse over time and I needed a revision since the dreaded double bubble was forming...
I have relocated back to the US at the beginning of this year and I started researching on surgeons. I have spoken to a lot of surgeons and I narrowed it down to Dr. Krau and Dr. Revis in Florida, Dr. Ciaravino in Houston, Dr. Pousti in San Diego and Dr. Pfeifer in New York City.
Since I currently live New York, I was inclined to go with Dr. Pfeifer for convenience and she has an excellent reputation for revising difficult cases but after reviewing a lot of her before and after photos, I am not sure if we have the same sense of aesthetics. Her results seems to be more natural looking while I am hoping for a lot of upper pole fullness :)
All of the other surgeons also have excellent reputations and have lots of experience with revisions as well and seems to do the high and full look that I love but I am not sure if their methodology would work for me. I have consulted with all of them through email and phone calls. I am very athletic and Dr. Revis, Dr. Ciaravino and Dr. Pousti wanted to use permanent sutures to do an "internal bra" to hold the implants in place and keep it from bottoming out/laterally displacing. It gets attached to the rib muscles and I've read some mixed reviews on that technique. It works amazing for a lot of ladies and they never had a problem afterwards, but for some they experience pain and discomfort - like an annoying nagging pain in their ribs that won't go away. Speaking to some ladies on a forum, some of them have ripped internal stitches as well doing upper body activity. Also, the idea that stitches holding me together forever doesn't sit well with me as well. But I am no doctor, this is just a personal preference of mine.
When I spoke with Dr. Krau - he said he prefers to use a thermal capsulorrhaphy technique. When heat is applied, the implant pocket will shrink up without the need for internal sutures. He mentioned that using internal sutures for fixing an implant pocket is like stitching your ear lobe to the back of your head. Yes, it will hold and sometimes it will hold forever but you are stitching two smooth surfaces together and they won't bond and form scar tissue so it will naturally fuse together in the long run. He was also the only surgeon that pointed out I had lateral displacement from the photos I've sent for the email consultations. He also perfers to use GalaFLEX as the ADM material instead of Strattice. Strattice has been around for a long time and is proven to be reliable but you need drains afterwards for the fluid buildup. Also the mesh in the GalaFLEX is also more porous so it encourages both collagen and capillary formation so when it dissolves after 1 year - 1 1/2 years, so you have strong scar tissue to hold up the implants after the mesh dissolves since it's made from a similar material as dissolvable stitches.
After much consideration I decided to go with Dr. Krau for my revision.