implants over muscle with Strattice internal bra?

wolfhoundmom

Next month I'm scheduled for implant revision for bottoming out and too much movement of my Mentor 800cc implant under the muscle, which happened only 4 months post T/E exchange. I've decided to do direct to implant prophylactic mastectomy on my remaining breast. New PS says he can eliminate implant movement, improve appearance and reduce pain by placing implant on top of muscle, and fat grafting. I'm soo sad to be in this position -facing a second mastectomy and redoing reconstruction almost a year to the day of my first surgery. Has anyone had it done this way?

DiveCat

hmm...I have heard of it done this way a handful of times for various reasons, but usually implants go under the muscle (with or without Alloderm/Strattice) to minimize rippling, visibility of implant, capsular contracture, minimize stress to tissue (which is higher with direct to implant as is!), reduce risk of explanation in event of infection, improve feel (otherwise you just feel skin covering implant), and add protection to implant. 

If your implant is moving a lot...it sounds more like the issue is with the size of the pocket in relation to the implant size. Pocket revisions can help with that. The bottoming out can be result of destruction of IMF by over dissection, weakened tissue, etc...this can be corrected by using Alloderm.

I would ask to see a lot of photos of his results using this method if you want to go that route, preferably a few months out and not when swelling is still high. I would also get a 2nd and maybe even a 3rd opinion.

I did direct to implant with Alloderm "internal slings" but my implants are definitely under the muscle (I am only just over 6 weeks out but am very pleased so far).

You might find this helpful: http://www.realself.com/question/breast-reconstruction-implant-top-pectoral-muscle

wolfhoundmom

Thanks for the info- I checked out the link, if I instead go with DIEP then I'll need to take another leave of absence and I really can't afford to.

I hope you heal well and continue to enjoy your new breasts. God bless!