Earlier Bottomed Out Question

Hi Dr. Roseberg,

Thanks you for your response on my earlier question regarding Bottomed Out of breast implants.  I have done some research and found out that most surgeons will use layers of sutures and/or existing capsules to 're-tailor' the pocket to correct this problem.  I have a couple of questions and would appreciate your opinion:

1)  Do you think this is a reliable method?  If so, would you use dissolvable or non-dissolvable sutures in your patients to correct this problem?

2)  I seem to have a bad reaction to this suture type - catgut when it started dissolving 3 weeks post-op, and am concerned that if there are sutures placed 'inside' my body, it may cause problems (of course I would not have catgut again because of my last experience).  In your opinion and from your experience, which type of sutures (dissolvable and non-dissolvable) would have the least tissue reaction or risk of infection when placed inside a breast pocket?

Many thanks in advance for your help.

[Howard Rosenberg, MD]

Correction of a bottomed out breast is probably best performed with the use of the existing breast scar tissue capsule to reposition the implant.  If catgut is a problem, then the use of a monfilament disolvable suture would be appropriate (like monocryl).