Breast implant revision to fix symmastia?

Question

First saline implants caused slight symmastia and pocket placement issues. 2 surgeons have 2 different plans. 1: under the muscle, switch to silicone implants, & create a neopocket. I would get implants removed, heal for 6 months, & get new implants. 2: deflate current implants, wait 3-5 weeks to heal, get new silicone implants put in over the muscle, use galaflex to create an internal bra. I am 5’5, small-frame, 140 pounds, and heavy weight train. Are both plans viable or is one better?

Matthew S. Kilgo, MD · Answer

Hello I’m assuming the implants are currently sub muscular in position? If so, either plan would be a reasonable option. What is important in the correction of symmastia is a pocket change. In my experience, creation of a neo subpectoral pocket can be challenging if you have a very thin capsule. I rarely stage these procedures. The decision comes down to whether you prefer sub glandular or sub muscular implants. Often, for my patients who exercise heavily, I recommend sub glandular placement to reduce unwanted animation with weight lifting. However, if you are very thin, the trade-off would be increased risk of visibility with subglandular implants. You should choose a surgeon who is certified by the American Board of Plastic Surgery and has extensive experience in revision breast surgery. Good luck.

Maryam Zamani (Saheb-Al-Zamani), MD · Answer

Hi Phenomenol,
Symmastia can be a challenging problem and as such there can be different solutions to it. Both proposed plans seem reasonable. As a surgeon experienced with implants both above and below the muscle and use of Galaflex as an internal bra, I prefer the second option considering some additional factors: You previously had saline implants which suggests your implants are under the muscle; therefore, going above the muscle can be a pristine pocket and less likely to cause symmastia recurrence. Galaflex can further reinforce this pocket and correct the symmastia. Lastly, since you weight train heavily, having your implants above the muscle will minimize the risk of movement and animation deformity with lifting and you would not have to adjust your activity level or workout regimen. 
Best,
Dr. Zamani

Gary M. Horndeski, MD · Answer

I would recommend removing the implants, waiting 6 months and then place submuscular silicone implants.  I also recommend smaller size implants as well.

Best Wishes,

Gary Horndeski, M.D.

Gerald Minniti, MD, FACS · Answer

Always under, always silicone. Make a neosubpectoral pocket if they are currently under. If current implants are over, make a new pocket under the muscle. No mesh necessary if making either a primary subpectoral pocket or a neosubpectoral pocket.

Connie Hiers, MD, FACS · Answer

Photos would have been helpful, but an examination is needed to be certain. Both plans do work for many women. You can keep saline unless placed in front of the muscle. I recommend going down in size for a smaller base.

Breast implant revision to fix symmastia?

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Answer: Symmastia

Answer: Symmastia

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Everything you need to know about Breast Implant Revision

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Breast implant revision to fix symmastia?

Answers (7)

Answer: Symmastia

Answer: Symmastia

Answer: Surgery

Answer: Surgery

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Recommended reading

Everything you need to know about Breast Implant Revision

Our mission is to create a world where every investment in modern beauty is Worth It.