During the last few years, I have noticed an increasing number of consultations for revision breast surgery at my plastic surgery practice. Given that millions of women now have breast implants, it is no surprise that many are seeking revisions after pregnancies, weight loss, capsular contracture or other issues.
As I tell all of my breast augmentation and breast lift patients, breast surgery requires maintenance because of the physics of breasts and gravity. Results are not meant to last forever, and additional surgeries at some point are to be expected. In many cases, we hope for 10 to 15 years before revision, but in patients with weaker skin or other issues, such as capsular contracture (scar tissue tightening around the implants), this time frame can be shorter.
In my practice, I always strive to provide the best possible results using the latest techniques and materials available. One relatively new material that has assisted me greatly in my ability to revise breasts is a soft, natural product from LifeCell™ called Strattice.
Strattice is what is referred to as an acellular dermal matrix. This is an FDA-approved material that can be used as soft tissue reinforcement. Strattice is derived from porcine dermis (the deep skin of pigs). I know, it sounds strange, but it is really a revolutionary product. The porcine dermis is processed so all of the pig cells are removed, leaving a framework, or latticework that your own cells and blood vessels can grow into.
One way to think of Strattice is as a soft leather that can be placed inside the breast pocked as an internal bra. But unlike leather, Strattice actually integrates with your tissues to become part of you. Strattice replaces scar tissue with healthy, regenerated tissue and can support naturally weak tissues.
By the way, the use of pig tissues is not new. Porcine heart valves have been used in humans for heart valve replacement for many years. In all of these cases, the body does not reject the material, because all of the pig cells are removed first, leaving a biologically inert framework.
In my Phoenix area plastic surgery practice, I have used Strattice for breast revision since 2009. I was one of the earliest surgeons to incorporate this product in my practice, and as far as I know, I have done more of these cases than most plastic surgeons in the country.
I originally started using Strattice for correction of recurrent capsular contracture cases. These were cases where patients had undergone multiple surgeries to remove excess scar tissue around their implants, but the scar tissue kept returning. Although Strattice’s FDA approval does not specify its use for correction of capsular contracture (yet), many studies have shown extremely low rates of capsular contracture in patients with Strattice or AlloDerm® (another LifeCell product similar to Strattice but derived from human cadaver skin). The Strattice presumably helped prevent capsular contracture by replacing scar tissue that naturally forms around implants with healthy, regenerated tissue. This helps prevent scar tissue from tightening up around the implants, leaving them soft and natural in appearance.
After some major successes with capsular contracture, I progressed to using Strattice for other cases, such as supporting weak tissues, reinforcing pocket repairs in patients with implant malposition (poor positioning of the implant), correction of symmastia (“uniboob”) and many other problems. Many of these cases are demonstrated in the corrective breast surgery photo gallery section of my websites.
To be clear, not every repair requires Strattice, but it can be a major benefit in certain patients and has probably had a more significant impact on my ability to help patients than any other product I have used since starting my practice.