i've had symmastia repair done twice... my breasts still dont look correct. i dont know what to do.i have gel implants under the muscle had alloderm put in it..... im 23 healthy. I really need help. my boobs are getting damaged from there surgerys and thong bras.... and everything i need a fix. what should my next step be?
What is Next for my Breasts? I'm Still Not Happy. (photo)
Doctor Answers 8
After reviewing your photograph, and of course this doesn't replace an in person exam, I don't see synmastia. There appears to be a well defined cleavage gap, so it appears the revision was a sucess. Maybe you're concerned about something else? I do notice lateral and inferior nipple position (Left worse than right), and this was likely a pre-exisiting issue that should have been identified by your surgeon pre-operatively, and would require additional scarring to correct. I also see a very small contour irregularity in the left medial cleavage that could be releated to the Alloderm, pec disinsertion or implant rippling.
Overall I would say that you should seek other opinions in person with a specific list of your complaints and concerns. If you came to my office I would then take that list and address each concern on 2 items. First, do I also agree with your level of concern about that issue and second, is the concern something that surgery will have a reasonable liklihood of fixing. More and more revisions introduce additional scarring, and often have diminshing returns.
Dear Ariana, your photo doesn't really show an obvious synmastia but it does show the marks of the compression you're using to control it in the medial aspect of your breasts if I'm seeing it correctly. Not knowing the surgeon that worked on you nor the technique utilised it is hard to make a judgement on how skilfully it was done. Synmastia is not an easy thing to correct because once the tissues are lifted from the chest wall it is very difficult to reattatch them. One of the options was already used which is to patch it with alloderm or other forms of acellular dermal matrix. Before this was available the only other way to acheive correction was to remove the implants and allow the pocket to close for at least a year if not more. Another important consideration is the choice in size of implants. Obviously the smaller the implant the more likely the correction will be succesful... DrBrou
What is Next for my Breasts? I'm Still Not Happy.
Stop having surgeries is the first step! Next allow 1 year healing time. Than you can re consider additional intervention like fat grafting.??
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Problems after synmastia repair
Your synmastia appears to have been adequately corrected. There is some medial wrinkling of the breast skin. This could be due to the attachment of the alloderm. I would certainly give it time for things to soften up before considering this the final result.
Unhappy with breast appearance following symmastia repair
Symmastia is not visible on the photo you have provided. If you are not happy with the appearance of your breasts, your next step should be in person consultations with board-certified plastic surgeons experienced at performing revision breast augmentation. Your history (including previous surgeries), a physical examination and a detailed discussion of your desired breast appearance is required in order to accurately advise you of your treatment options.
How to correct symmastia..
From your photo, I cannot appreciate symmastia. However, without direct examination, it is hard to determine that. Correcting symmastia can be a challenging operation. Normally, I would use dermal matrix (such as Alloderm) to re-create the implant pocket. I agree that too much surgery is not good. Talk with your plastic surgeon and express your concern and see whether she/he can address your concern.
What is Next for my Breasts? I'm Still Not Happy
The symmastia is not present, and I would not operate again at this point.
Kenneth Hughes, MD Los Angeles, CA