I've been suffering from symmastia for more than 10 years and have had several attempts, more than 5 surgeries, to correct it. I almost gave up but one surgeon assured me that he could correct it. After the surgery, I was in so much pain and had severe seroma and my incision finally gave out and I could already see the implant. He explanted me and after 4 months, he inserted new implants. Now I'm having seroma again and I could see the implant again from the incision that gave out.
Incisions Have Given Out After Symmastia Repair, What Should I Do?
Doctor Answers (5)
It would be a help to see photos of where you are now to beter advise you. The success of symmastia repair depends on many things. The fact that you had symmastia for so long and, likely, mature capsules around them makes repair difficult and there are certain issues that must be addressed. For example- knowing how your implants were placed initially- over or under muscle- what type, size & style implants, and exactly what was done to correct the symmastia, could all help to advise you. Contrary to what many other people have written, I don't believe dermal matrix really adds any advantage in most cases although there are rare cases where it is an option. Sometimes, and most patients don't like to hear this, the best course of treatment can include removing your implants for a while after a repair and then reinserting them on a delayed basis. Again, it depends on your situation. Good Luck! Scott Newman, MD FACS
Sorry that you are having such a tough time. If you keep developing seromas, perhaps you have an underlying infection, or other problem that needs to be investigated. Often symmastia can be treated by developing a new pocket for the implant and/or adding an acellular dermal matrix inside the pocket to reinforce the repair.
Complex implant history
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Keys to successful symmastia repair
Although the question doesn't include enough information about your previous surgeries to know why you have had so many problems, I can tell you what I believe is required in order to correct symmastia. The first thing is to use implants that are not too wide in diameter so there is less pressure against the repair. Secondly, if it has been repaired once and failed, the repair needs to be reinforced with an acellular dermal matrix (ADM) graft such as Strattice. Third, especially when an ADM is used, suction drain tubes need to be in place for a minimum of 5-7 days to prevent seromas.
Based on your history, it sounds like you have had a very difficult experience in regards to your breast augmentation operations. It would behoove you to find a well experienced board-certified plastic surgeon who has significant experience with correction of symmastia and revisionary 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 experience treating this problem. You may find the link attached below helpful.Best wishes.