Symmastia repair has not been successful! What do I do now? (photos)

Symmastia is almost always the result of a technical issue and not primarily due to the 600 cc implant that was initially placed.  Improvement is possible but you should wait longer because you may see more improvement and it can make the next procedure easier.  Most surgeons would wait at least six months prior to attempting another repair for this condition.  

Symmastia is a condition which can occur when the implants are too close together. Patients often refer to this as a “uniboob.” Occassionally, the space or pocket for the breast implant is created towards the center, or the tissue stretches, forcing  the implants to fall too much towards the center of the breasts.  Correction of this problem may involve using different implants such as textured, a smaller size, or a smaller base and placing the implants in a new pocket. On occasion, this may require surgery in more than one stage to allow the tissues to heal and then place the implants. If the implants have been placed above the muscle, converting them under the muscle frequently will help and, again, the use of a dermal substitute may be required for additional support if the tissues are thin. The techniques of capsulorrhaphy and neopectoral pockets may apply here as well.  Additional elective cosmetic #surgery is a personal choice. Your procedures should always be performed by a #PlasticSurgeon who is board-certified and has a great deal of experience specializing in cosmetic #surgery. You will then greatly improve your chances of getting the result you desire, and, without the need for a revision surgery. It is suggested that you look at before and after photos of the surgeons actual patients, and read patient reviews. Gathering all of this information will help you make a well-informed decision.

Thank you for your question and providing photos. It is difficult to comment not knowing what type of repair was actually done. I would recommend waiting another 3 months before considering a revision. With the use of permanent sutures and reinforcement of the repair with an ADM I believe the problem would be corrected. Best of luck

Thanks for your question.  Symmasita repair can be very challenging at times.  Looking at your pictures, I believe that your 400 cc implants are still too large for your frame.  The combination of the remaining breast tissue and the large implant makes it impossible for a successful repair of the symmastia. Not only the implants have moved medially to cause the symmastia, they have also migrated laterally in the axillary area as well.
My recommendation would be to down size your implants and have have the pockets tightened and addressed with sutures and/or biologic meshes (ADM) to reinforce the repair. A second opinion is always a good idea.
Good luck and I hope this was helpful.
Ali Sadeghi MD FACS

Your plastic surgeon will be your best resource when it comes to your specific healing and concerns.   Generally speaking, it does take time (several months) for patients to see the final outcome after this type of surgery. For example, swelling will dissipate and breast skin/tissue that was previously elevated will take time to "bounce back" after downsizing of breast implants and capsulorraphy surgery.  I find that the use of compressive tape/dressings along with the "symmastia bra"  may help during the healing process.If, in the longer term, you remain concerned, additional surgery may be necessary/helpful. Maneuvers may be helpful capsulorraphy, liposuction of the pre-sternal area, and the use of acellular dermal matrix along the medial breast borders. You may find the attached link helpful to you as you learn more. Best wishes.

Thank you for the photos and sorry for your problem  which can be corrected.  So get your preop photos and operative record and see some experts who can help youDr Corbin