After Internal Bra (Internal Sutural) Procedure for Synmastia Repair? Does This How It Usually Looks? My Chest is Sore. (photo)

I am 5'0, I am in my early 20s. I had 350cc implanted and I had severe synmastia and bottoming out.

Doctor Answers 6

Synmastia and Bottoming out problem

I certainly do not  like the way your skin is pleated even at this early period.  Really need more information to understand the technique used, was an ADM like Strattice used to support the implant.  

Atlanta Plastic Surgeon
4.5 out of 5 stars 19 reviews

Concerns after Correction of Symmastia?

Although you ask good questions, online consultants are not your best resource at this point;  your plastic surgeon should be your resource given that he said/he knows exactly what was done, what activity restrictions should apply, and is responsible for your care.  Follow-up with him/her and do not hesitate to discuss concerns/questions.

 Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,488 reviews

After Internal Bra (Internal Sutural) Procedure for Synmastia Repair? Does This How It Usually Looks? My Chest is Sore.

Based upon the posted photos there is some concern in the suture techniques. But again over the internet very hard to advise and more healing time is needed. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 173 reviews

Synmastia repair.

The internal suture technique alone for synmastia repair is difficult at best to prevent recurrence. Your photos show significant indentation of the skin and what appear to be oversized implants. However, internet evaluations do not supplant an in-person exam. I prefer a multi-step approach to synmastia repair:

  1. Be sure the implants are within the anatomic dimensions of the breast (implant width < breast width), if not - decrease the implant dimensions!
  2. If subglandular, switch to a submuscular pocket (new implant space)
  3. If submuscular, create a neo-subpectoral pocket (new implant space)
  4. Remove any capsule which overlies the sternum or create a capsular "flap" to wall off the sternal space.
  5. Use Strattice or a similar dermal matrix if necessary to prevent migration of the implants over the sternum.
  6. Use internal sutures as necessary without creating external puckering
  7. An external "thong" bra to keep even pressure along the sternum.

As you can see, correction is not a simple "throw some stiches" solution. Even with all of these techniques, synmastia is difficult to correct. The best outcomes are for those patients with subglandular implants who desire smaller implants as switching to a submuscular pocket with appropriate sized implants allows for the easiest and most predictable correction.

David Bogue, MD
Boca Raton Plastic Surgeon
5.0 out of 5 stars 25 reviews

Stmastia repair

This is tough.It will get better with time.I would be patinet and give it a few months.This is a tough condition to treat.

Robert Brueck, MD
Fort Myers Plastic Surgeon
4.9 out of 5 stars 62 reviews

Internal bra for symmastia repair

It is hard to tell from the pictures, but the internal bra procedure would use an acellular matrix material such as Strattice. In any case, there appears to be swelling as it is early post op so too early to tell. Give it some time and make sure your plastic surgeon is aware of your concerns.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 52 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.