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Dr. Babak Dadvand discusses Strattice Use in Breast Revision

Posted on Tuesday, July 24th, 2012 by Dr. Babak Dadvand

As more and more women undergo breast augmentation, the number of breast revision surgeries will increase. Some revisions are straightforward, e.g. women who want to go bigger or smaller, or remove the implants all together. Other types of breast revision surgeries can be quite challenging, such as in women who have multiple capsular contractures, severe wrippling, or implant malposition. In some of these cases, using the patient’s tissues alone will not bring about a stable long term result. These cases require products such as Strattice, an acellular porcine dermis manufactured by Lifecell.

Women who have developed a capsular contracture are at  higher risk to develop another capsular contracture with revision surgery. Needless to say, women who have had multiple surgeries for capsular contracture are the most likely to develop another contracture with surgery. In these case removing the capsule and using a new implant may not be enough. Using Strattice may help prevent recurrent capsular contracture. The Strattice is sutured in the lower part of the breast and covers the lower half of the implant. Capsules have been demonstrated to not form to the same degree across the Strattice. For a capsule to become truly constrictive, it needs to be circumferential around the implant. With the Strattice in place, this will not happen.

Some women have severe thinning of their skin and tissues to the degree that the implant is palpable, and in worst case scenarios visible. Using a product like Strattice adds thickness to the patient’s natural tissues and covers the implant, thus reducing or eliminating wrippling.

Another great use of Strattice is in women with implant malposition. Malposition can take on different forms, such as symmastia and bottoming out. Symmastia, which I discussed in a blog entry, occurs when the two implant pockets connect, eliminating the cleavage and turning the breasts into a “uniboob”. Bottoming out, which I also discussed in a prior blog, occurs when the breast fold is disrupted leading to the implants being too low.

In both of these cases, using intenal sutures to recreate the implant pocket may not lead to long lasting results because these patients generally have thinned out tissues that won’t be able to hold the sutures in the long run. Strattice is a very good solution in these patients to recreate their natural anatomy and give support to the implants.

So why isn’t Strattice used in all breast revision cases? Well not all women need Strattice to address their specific problem. A secondary issue is the additional cost of Strattice which can be between $1500-$3000 a piece just for the Strattice. But in select patients, this cost is more than justified if it will give them long lasting solutions to their problems.

To learn more about breast implants and revision breast surgery  and to view before and after pictures visit my website at drdadvandplasticsurgery.com.

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