Allograft (Alloderm), Breast Enhancement, Internal Sutures (Internal Bra), Revision Breast Surgery, Symmastia Repair

This 36 year old patient interested in breast revision surgery. She desired to correct her implant asymmetry and implant mal-position. She was unhappy with the symmastia she was experiencing. Symmastia – commonly referred to as “bread-loafing” or “uni-boob”, occurs when two implants touch one another in the center of the chest. If the horizontal muscle that is connected to the sternum and goes across the implant is cut during surgery, then the implant can move toward the middle of the chest. Symmastia results from overly aggressive attempts to alter chest wall anatomy trying to increase cleavage in patients. This outcome is made worse by use of larger implants in thin patients, and is a problem for implants over or under the muscle, though sub muscular implant placement allows the muscle to provide some softening of the transition to the cleavage area from the augmented breast mound. She had her consultation the day prior to surgery. Capsulorrhaphy (internal bra) is performed to correct the implant mal-position by closing off the breast pocket. Bilateral acelluar dermal matrix helps support internal repair. AlloDerm is made from donated human skin. It is handled in much the same way as other transplantable organs. The tissue is processed to remove cells that might cause your body to reject the foreign tissue or react negatively to it. What’s left is the collagen structure (fiber-like proteins) and other proteins naturally found in skin. This structure acts as a frame for your tissue to grow into and around. The patient is currently 6 days post surgery and has bilateral 435cc high profile breast implants.