Breast Implant Revision with Strattice

I’m 5’7”, 140 lbs, 51 years old. Primary BA was in July, 1993, 270 cc textured saline over the muscle resulting in a full C cup. Fast forward, 27 years, I seem to have a bit of mild CC that has slightly shrunken the right implant. The left migrates a bit into my armpit when laying down. Overall, I have been very happy with my primary BA, but it’s time to remodel. My initial thought was to stay the same size or maybe a little larger.

I had an initial phone consultation with Dr. Salemy after sending current photos to the office for my chart. He recommended Sientra HSC silicone implants and strattice to create an internal bra, reduce the risk of CC and end up with what he called “a robust” result. He will remove the current capsule and construct a new pocket under the muscle. He said he’d do his best to get the desired result, but that it’s possible I could be smaller as a result of going under the muscle and depending upon my tissues and what they are capable of.

After my initial phone consultation, I discovered the condition called “animation deformity”. I did a LOT of research and developed many questions about the condition and the strattice. I called the office and was set up with another phone consultation, at which time I was able to get them all answered by Dr. Salemy. He also noted that I had a pre-op appointment 1 day prior to my procedure date. He was perfectly willing to do that, but said to give him the best chance at getting the result I’d like, converting the pre-op appointment to an in office appointment 2 weeks prior would be best. I opted to schedule that so he can measure and have the best sizes available for my surgery.

I’m getting ready to have my pre-surgery clearance. Then my in person pre-op in mid October, followed by surgery in early Nov. 2020.

I was apprehensive about the whole thing at first. But the more research I did, the better I felt about it. I’m completely confident in Dr. Salemy’s skill and care. His office staff has been very responsive. I’m actually feeling a little like a kid waiting for Christmas. I’m excited to get this done and have my newly remodeled “girls”.

I will post a review update about the strattice, as there are not many on that subject yet. More to come :)

*I am writing this "after the fact", but wanted to go in order of events as they happened.

I had my preop visit with Dr. Salamy on Friday, Oct. 23, 2020. We talked about size of implants and reconfirmed the procedures he would perform (explantation, capsulectomy, pocket reconstruction behind the muscle and new implant placement).

The size range would be between low 300's and 470 cc's. He would do his best to get me where I requested (around 450 cc's) as he could, without setting me up for problems down the road. Individual anatomy and what it will withstand and support is of the utmost importance.

I have every confidence in Dr. Salamy. Surgery is scheduled for Thursday, Nov. 5, 2020.

Yay! I finally had my surgery. Everything went great. I had no intention of writing a review until I found that there was so little information and reviews using Strattice. But I have learned A LOT in other ways here. So I decided to give back to this community from which I’ve learned so much in these last couple of months and write about my experience with Strattice in revision.

First, the stats, then my experience.

I received Sientra, high profile, highly cohesive silicone, smooth, round, 440 cc implants behind the muscle with bilateral Strattice.

Dr. Salemy removed the old textured, round saline implants and performed a capsulectomy. He created a new pocket behind the muscle and attached Strattice to the free edge of the muscle which also extended up the lateral aspect of the breasts. After implant insertion, he stitched the bottom, free edge of the Strattice under the implant to the chest wall to create the internal bra/support.

Here’s how it went...
I arrived at my check in time and was brought back to a “ready room” by a wonderful nurse named Victoria. She helped me get ready for the surgery, took my blood pressure and went over the preliminary “what to expect” stuff. She told me that I might wake up experiencing a burning or stinging sensation because of the capsulectomy and the nerves having been disturbed. She assured me that it was normal and didn’t want me to be alarmed. I appreciated her letting me know this, and thankfully, I did not experience any burning or stinging.

I got dressed in the gown with the opening in front. Dr. Salemy came in and we discussed (once more) my goal for size. I started with 270 cc saline (full C cup on my anatomy) and wanted to add a cup size to make me a “D” cup. By my non-expert calculations, I thought that to be about 450 cc’s. He confirmed that. I also told him that I deferred completely to his expertise and experience to give me the size that would be safe for my anatomy, even if that meant going smaller than my requested 450-ish. We were on the “same page”. He made his markings on my body for surgery.

After that, I change my gown to open in the back and put on a warm, plush robe. Then Dr. Marshall, the anesthesiologist came in. She was so thorough and personable. She explained everything that would happen once I got into the OR.
Step one was the placement of the IV (which I barely felt). There was to be some kind of agent put into that to relax me.
Step two was to be a mask of 100% oxygen to get my lungs ready for the anesthesia. I do not remember ANY of this or anything else going forward until I woke up. She said I was a “lightweight”.
Step three was the total knockout with monitoring, etc.

Before I was out, I also recall nurses putting compression booties on my feet and legs and something going on with my right arm extended (though I don’t know what that was). The room was a bee hive of concerted, organized activity from at least three fronts all at once.

The next thing I remember was waking up in the recovery room next door with my nurse, Victoria and Dr. Marshall attending me. They were great and made sure that I was comfortable and doing well. I was already wrapped with a double ACE wrap (over my compression bra) that put plenty of pressure on my chest to keep things from moving at all over night (and maybe to keep swelling down?). It was a little tough to get a full breath, but it was manageable.

I had no nausea and I think I spent about 45 minutes in recovery. Victoria called my husband to let him know that I was out of surgery and that he could start on his way to pick me up. A bit later, she wheeled me down to discharge me to my husband’s care and explained to him how to care for my drains, pain meds,etc.

The first night after surgery - pain was well managed with Gabapentin, oxycodone and Tylenol. I couldn’t take the Celebrex because of other medical history. But these pain meds are doing the job. I did get a bit of nausea after taking the oxycodone the first time. The sublingual, anti nausea medication prescribed to me knocked that out within a minute or two and I had no more nausea going forward.
I was able to eat and slept reasonably well in an upright position. Asking for extra bed pillows ahead of time at the hotel was a smart move.

Day 1 post op / 1st Post Op visit - my first post op was the next morning following surgery. Carly, my nurse for today, cut the two Ace wraps off of my chest. It was like my boobs were freed (even in the compression bra) and they were let out to breathe.

Then the bra was opened. Yikes! They were a bit misshapen because of the Ace wraps. They were also kind of wrinkled up. But I knew that they would improve very quickly. Heck...they even improved a little while I was waiting for Dr. Salemy to come in.

Dr. Salemy said that the surgery went well and that it was good that I had the old implants taken out. They were intact (even after 27 years!), but the capsules were as hard as rocks, especially on the left side. He also said that everything was looking exactly as he expected and he was happy with the results. He asked if I was happy with the size. In short...I’m thrilled.

Day 2 post op - I have drains on each side that should come out on day 4 post op. They are not terribly uncomfortable or hard to maintain at all. But they do have to be “milked” once or twice a day to keep them from clogging and to get a more accurate record of fluid expelled.

I can feel some soreness in my center chest and ribs underneath my bust. Also some “bubbles” that are moveable under the skin on each side under my bust (weird in a funny sort of way). I’m a little bloated in the belly, but nothing terrible. I’m still waiting for the stool softener (and today’s laxative) to kick in. Coffee this morning had no affect on the situation.

Moving on (no pun intended)... the right side seems to be riding a little higher than the left. I’m hopeful that will even itself out over time. I know that they’ll both drop (and fluff) over the next several weeks. My incisions are covered with steri strips and are giving me no trouble at all. The drain hole incisions are a tiny bit tender when it’s time for meds. In general, I’m not in pain unless it’s time for meds or I move my arms too quickly or too far away from my body.

The Strattice - Since the old, over the muscle capsule was removed, I have a bit of softness/laxity in my breast tissue on the lower pole. There is more softness on the right side (because the implant is higher up on that side). I can NOT feel the Strattice or the stitching at all (yet?). There’s a LOT of sewing in there. I assume that as the implants drop, the softness and laxity in the lower pole will fill in and become more smooth.

I have some numbness in the center of each breast in the upper poles and surrounding them going out in a circle about 2.5 - 3.0 inches across. I believe this will resolve in short order as the nerves regenerate and get happy again. I’ll report on that later.

Right now, the shape of each breast is a bit flattened because of the compression bra. They are round. But I believe they will round out and project more throughout my recovery.

I slept like a rock last night upright in an adjustable bed with a pillow under my knees. I think that is key and I highly recommend an under the knee pillow to keep your low back from hurting and to keep you from sliding downward in the bed.

In general, I feel great. Just a bit tired (and like I’ve been in a fight), generally good. More to come. I welcome questions and am happy to answer.