Does that sound right? i'm 3 months post-op of a revision from 500cc silicone HP to 800cc saline mod+ filled to 800cc (left) and 960cc (right). i noticed my breasts coming too close together initially and was worried but thought it was just tenting. i then saw my PS a month ago and as i stated in title, that's his plan. now at this point i'm 99% sure it's symmastia. i'm not convinced this will be enough to fix it. what do you think?
I have symmastia. My surgeon's plan is to reopen my pockets laterally to give the implants more room? (photo)
Doctor Answers 4
Factors in successful symmastia repair
First the base diameter of the implants has to be within the anatomic dimensions of the breast, which is not often the case with 800 cc implants. Second, making room for lateral movement with a capsulotomy will be helpful but can lead to weakening of the pocket so it has to be done carefully. The most difficult part is restoring the boundary of the pocket along the cleavage, and reinforcement with Strattice or SERI scaffold mesh will help increase the chances of success, especially with larger implants.
You do have synmastia. This is difficult to correct. I agree that more room has to be made laterally in conjunction with medial repair. This does have a significant failure rate. You can also consider using ADM or strattice for the medial repair
Correction of Symmastia?
Thank you for the question and pictures. I think that you will benefit from bilateral medial breast capsulorraphy (internal suture “repair”) as well as lateral capsulotomy to improve your situation. I would also suggest you consider inferior capsulorrhaphy as well. This procedure will serve to improve the position of your breast implants on your chest wall, better center the nipple/areola complexes on each breast mound, and better hide the inframammary fold scars.
It may also be necessary to change breast implant profile or volume to help prevent chances of recurrence of breast implant malposition.
I hope this, and the attached link, helps.
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Repair of synmastia and breast implants in Los Angeles
Synmastia has many variants. It is customary, in most cases, to perform a capsulorraphy of the medial pockets.
Raffy Karamanoukian MD FACS
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