Symmastia After Breast Augmentation

I had breast augmentation in 2006. My surgeon quickly noticed that I had symmastia and had told me that it was no big deal and it should improve over time. Then in July of 2008 he suggested to me that he could put sutures in the middle and change my implants to fix it and I only would have to pay the anesthesia and for the new implants.

Well it’s been 7 months and I still have the same problem except that I have bigger scars on my nipples and scar tissue on my right nipple that causes it to point down. What do I do? Please help!

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12 Doctor Answers | Asked by asianredneck in ft.lauderdale,fl,usa

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Symmastia

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... more

Synmastia Treatment

As my colleagues have stated, 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 out. If the implants were initially placed above the muscle, this can be improved with a site change surgery where the new implants are placed under the... more

Synmastia blues

Asian Redneck (I love it), Synmastia is a vexing problem that is sometimes difficult to fix. I would assume that a capsulorrhaphy (stitching closed the capsule that contains your implant) was done at the time of your correction. This may be an incorrect assumption, and if it is, may work to your benefit. If your capsule was not closed, then you may still be able to have this done. Talk to your surgeon about whether this was attempted or not. If not, he/she may be willing to go in again... more

Synmastia is very hard to correct

Some patients have an anatomical predisposition to central migration of their implants if they have an inward angling chest wall. In these patients, a good gap between the two pockets assists in preventing synmastia. Sometimes, the pocket is incorrectly dissected and sometimes a patient can be too vigorous in massage or wear push up garments too early and brake down the barrier above the sternum. Fortunately, synmastia is rare because it is very difficult to treat. Probably the two... more

Symmastia after breast implants can be corrected,

Hi. I don't quite agree with my colleagues. Symmastia after breast augmentation can be reliably corrected and it is not that hard. The surgeon has to create a new implant pocket or "neopocket" for the breast implants, and the new pockets don't come anywhere near each other.

Symmastia is not easy to repair.

Hello, As the other surgeons here have noted symmastia is not easy to fix. You probably need more surgery and smaller implants. The ways to fix this are not standard. See your surgeon and make a game plan.

Symmastia

Symmastia is a condition that can be very difficult to treat. The easiest way to treat this is by switching from a subglandular pocket to a submuscular one. It also may help to use smaller implants if they are quite large. Suturing the pockets in the midline can help for specific conditions.

Steven Wallach, MD

12 reviews

Manhattan Plastic Surgeon

Symmastia is a very complex problem! Continue to see your plastic surgeon.

Thanks for your question. I think it is imperative that you continue to follow up with your plastic surgeon. He certainly understands your anatomy and the procedures he/she performed. Everyone agrees that symmastia is a very complex problem. It sounds from your description that revision surgery is required and may take more than one procedure. Depending upon your examination and clinical findings, you may be required to dramatically reduce the size of your current breast implants or... more

Synmastia is a challenging condition

Synmastia is difficult to treat. It may require more than one operation and as my colleagues have stated, there are many options and sometimes different procedures may need to be performed in order to correct. These include: 1. Removal of the implants at procedure; 2. Using textured implants (these have a tendency to "velcro" in place) avoiding surgery near the breast bone (sternum) 3. Removal and Replacement of the implants in a new location i.e. "overs" to... more

Otto Joseph Placik, MD

32 reviews

Chicago Plastic Surgeon

Symmastia is difficult to treat

Symmastia is difficult to treat. It may take a staged approach where you remove the implants and allow everything to heal. Then go back in about 6months for re-augmentation with more attention paid to making the pockets smaller and using a smaller implant. Otherwise, your surgeon may discuss with you the use of a dermal substitute to close the connection between the two breasts. That would be done in one surgery but will be more costly. Discuss your options with your surgeon and be patient... more

Many options, few solutions...

Synmastia following breast augmentation is a difficult situation. I am assuming the synmastia is completely the result of the augmentation and consists of the joining of the pockets on each side in the midline thus allowing the implants to touch in the middle through this tunnel. Suturing this tunnel closed is virtually impossible although many will try. You can possibly remove the implants for a few weeks/months and then start from scratch. Another recent technique is to try to dissect a... more