Breast Augmentation: Q&A
Ask a QuestionI Had BA Surgery One Year Ago and Ended Up with Symmastia, Severe Muscle Distortion and Possibly Bottoming Out - Any Advice?
Pre-Op I was a very small 32AA-left breast was smaller and higher than the right. Post-Op 32C-300 cc saline submuscular. Nervous for revisionary surgery-None of my problems are even anywhere close to being a permanent fix. Switch to over muscle, internal sutures, change to smaller silicone, Possibly just remove implants? Trust my PS?-He seems shocked that this happened. Could I end up in a worse position after revision? Any advice would be appreciated.
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20 Doctor Answers |
Asked by
Detroit1152
in Detroit, MI
+3
PHOTOS: Double bubble, bottoming out, synmastic ("uni-boob")
There are so many separate conditions that it would be difficult to fix in one stage. However, if this were your wish I would consdier a neopectoral pocket with dual plane dissection and smaller implants with possible radial relaxing incisions or fixation of the IMF with Acellular Dermal Matrix after a thorough discussion.
+2
Symmastia surgery
Symmastia (medial malposition breast implants) can be corrected with high likelihood of success using medial breasts implant pocket sutures (medial capsulorrhaphy), lateral capsulotomy (if necessary), and/or the use of allograft. I do not believe that a staged procedure, involving removal of implants for period of time, is necessary.
There is a learning curve with this operation and I recommend that you seek consultation with a board-certified plastic surgeon with significant...
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+2
Treating symmastia may require the use of Strattice
Bottoming out of breast implants usually requires removal of the implants, tightening of the pocket underneath with stitches, and replacement of the implants. For the symmastia, Strattice is a xenograft piece of tissue that can be used to "wall-off" the middle of your chest in order to prevent the implants from moving together. The pocket tightening and Strattice placement can be done at the same time as an outpatient procedure. Good luck!
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+2
Symmastia after breast augmentation
Although uncommon, symmatia can occur after breast augmentation. Your implant diameter is too wide; and your implants are too close together. I would use a smaller implant and utilize Alloderm (acellular dermal matrix) as a sling medially to give support. It is a challenging problem to correct; however, it can be done.
+2
Synmastia Treatment
It is difficult to assess your problems from the quality of your photos. There seems to be multiple issues going on here. I will address the synmastia.
Synmastia is a challenging problems to fix. Synmastia clinically manifests as a "uni-breast" where the cleavage (space between breasts in the area of the chest plate) has been lost. Anatomically, usually it is because the medial aspect of each breast pocket has been over dissected or stretched...
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+2
Asymmetric breasts after breast augmentation
There are a number of issues evident from you photo. Muscle activation distorts the breasts, the implant base diameters are too large for your chest/rib cage size, the nipple complexes are both too far from the midline, the inframammary folds are both too low so the implants are not centered under the nipples (even if the nipples were in the proper position). You may keep the same size of implant in terms of cc but you will need to get implants with smaller base diameters. You...
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Los Angeles Plastic Surgeon
+2
When breast implants are just not working out, symmastia
With a multitude of problems after breast augmentation such as low pockets and implants that run together in the middle of the chest, symmastia, it is very understandable that you cannot trust your plastic surgeon. I feel the best choice is to remove the implants and let your chest and breast fully heal and recover, and consider replacement at a later date when shaping the pocket and positioning the implant become more predictable. Sad to start over but your present situation is dreadful...
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+1
Breast Augmentation with Symmastia, Muscle Distortion, and Bottoming Out
Hello,
I'm sorry that you've experienced these complications following your breast augmentation. However, each of these issues can be improved, but will, of course, require revisionary surgery.
1. Symmastia- symmastia, or "uniboob" can likely be corrected by placing your implants in a new plane (in your case, above the muscle or above the muscle but under the muscle fascia). Using a smaller implant with a smaller base diameter will decrease...
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+1
Breast implant revision
Many of the recommendations provided are good to consider. Give thought to obtaining a 2nd or 3rd opinion. Ask about costs of revision as some of these options require additional costly materials (AlloDerm and similar products).
Based on what you describe, your surgeon may want to consider making a new pocket for the implants above the muscle and place smaller silicone gel implants.
+1
Revision surgery is needed.
I don't agree that your implants are too large for your chest having caused this problem. A revision surgery is needed to separate the 2 pockets but I think you can still pick how large you would like your breasts to be. This is an unfortunate problem you have, but don't loose hope - it can be repaired. Good luck!
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.
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