14 months breast augmentation post-op and I have skin tenting. Will this ever go away? (Photo)

500cc hp submuscular implants with skin tenting. I wore a thong bra for 6 weeks after the surgery. I just noticed that my skin tenting is worse so I started wearing my thong bra. I have a tugging feeling on my sternum. My PS says it would be "unusual" to develop symmastia this late. She will perform a bilateral capsulorraphy of the medial breast and reduce the implant size, if I would like a revision. I am just curious if I should have a revision or leave it be. Am I at risk for symmastia.

Doctor Answers (10)

Inpending symmastia

+1
Thank you for your breast augmentation question.


  • Your implants are large.
  • The photo and what you say is happening - increased tenting, tugging on the sternum - is impending symmastia.
  • You should have a revision with a significantly smaller implant.
  • Be sure the implant actually fits your chest frame by measurements.
  • Once symmastia develops it is harder to fix - implants need to be removed and not replaced for about 6 months. 


Atlanta Plastic Surgeon
4.5 out of 5 stars 21 reviews

Breast implants

+1
Thank you for your question.  Based on your photos and without the benefit of an examination it does not appear that you have symmastia. The implants appear to be separated and do appear to communicate. The decision for revision all depends on whether you are happy with their appearance.  If you were going to undergo a revision then you would benefit from a higher profile implant that would give you projection while having a narrower base. Good luck.


Arun Rao, MD
Tucson Plastic Surgeon
5.0 out of 5 stars 5 reviews

Synmastia

+1
From the photos, it does not appear that you have synmastia, just very medially positioned implants.  Since you're over a year out from surgery, the implants should be well healed in their capsules, and shouldn't more any more medially or develop more severe synmastia.  So, if you like the look of your breasts, then there is nothing to do, and if you would rather have a bit more space between the breasts, then a revision is the only way to achieve this.  Also important to think about, revisions are never cheap because to prevent the implants from moving back to this medial position, your PS would need to reinforce the medial portion of the breast pocket with a type of biologic mesh.  Revision surgery is also not without its risks of infection, or under/over correction.

Kyle Song, MD
Irvine Plastic Surgeon
5.0 out of 5 stars 12 reviews

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Revision if the size or appearance of the breasts/cleavage is an issue

+1
Dear crossfit123,

If you like the size of your breasts and the appearance of the cleavage area then nothing needs to be done.  If you think your breast implants are too close together or if you think your breasts are too big then I would consider going with a narrower implant and modifying the pocket a little while your plastic surgeon is in there.

All the best,

Dr. Remus Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
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Skin Tenting?

+1
I do not appreciate the tenting that you speak of. Your implants look really good in the pictures you posted. I think your shape is good as well. 

Richard J. Brown, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 20 reviews

? Symmastia

+1
At fourteen months, I think it unlikely that symmastia will develop. If you are happy with the size, I would suggest leaving things as they are. Nothing can be done that doesn't have some risk!

If you feel these are too large, that may be a reason for a revision, and if so a capsule repair can be done. 

I don't think a wait and see approach would make it any harder to repair in the future if things get worse or if you decide later that you don't like your result. 

Best wishes. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.5 out of 5 stars 31 reviews

14 months breast augmentation post-op and I have skin tenting. Will this ever go away?

+1
This far out from surgery it will not improve on it's own. It is a little difficult to tell in the photos as in some it definitely appears like you have the makings of symmastia but in others not as much.  If it bothers you then surgical repair is the best/only way to tackle the problem.  

Megan Jack, MD
Boca Raton Plastic Surgeon
5.0 out of 5 stars 4 reviews

Symmastia

+1
Hello,

The appearance of your breast implants is certainly on the verge of symmastia.  No one can assure you that it may or may not get worse with time, however there is no doubt that it looks abnormal and could be improved. 

Capsulorrhapy is an excellent procedure for pocket closure in the inferior and lateral regions, but frequently is ineffective medially.  My recommendation is the use of another technique that circumvents the need for pocket alteration by creating a new submuscular pocket. The old scar capsule is obliterated by sewing the front portion to the back portion.  A new pocket is created over the capsule but still under the muscle. Great care is taken to limit the new pocket's dimensions toward the sternal area.  The 'lifted' skin over the sternum is now protected and does not rely on sutures to hold the implants back.

If your surgeon doesn't know this technique, you should have a consultation with a few surgeons that do.  I have found it to be a reliable way of ensuring permanent separation of the implants.  Although not necessary for success, you may consider smaller implants as these would be shifted laterally after the procedure, possibly making them too prominent in the lateral chest area.

Best of luck!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 29 reviews

Symmastia

+1
Thank you for the photos and technically from them you are already developing symmastia and would benefit from a revision in the near future 

Dr Corbin

Frederic H. Corbin, MD
Brea Plastic Surgeon
5.0 out of 5 stars 27 reviews

Risk

+1
I think you are at risk with or without surgery, the stretching has been done and correction is difficult if it is not advancing that you are probably fine and I would just leave it alone if you are ok with it

Ryan Neinstein, MD, FRCSC
New York Plastic Surgeon
5.0 out of 5 stars 37 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.