How long will breast aug symmastia reconstruction recovery take? (photo)

Question

Hi there! I went in for breast augmentation May 26, 2016. I was a 32A and am now a 32D with 275cc mentor saline implants filled to 300 (right) and 340 (left). In December i noticed that my breasts were touching in the middle and that the outside looked squished. After going in to see my PS this spring he told me I had symnastia. I am scheduled for July 13 procedure. I drive back down to college August 11. Will this be enough time to recover?

Luis M. Rios Jr., MD · Answer

Wow! I admire the optimism and positive attitude. 
August 11th will give you about one month into your recovery. Although you can probably drive, I would advise you not to do any heavy lifting until about 6 weeks after your surgery. Please have this discussion with your surgeon.  Synmastia repair is a tricky surgery and you need to diligently follow instructions to insure a good outcome. 
Now, looking at your photos, I have a few things to consider that might make your appearance better and help the synmastia repair. First, I think one of your options is to do the repair and consider using smaller implants. By decreasing the volume, you will put less pressure on the synmastia repair. If you decrease the volume, you could also consider a procedure to raise the implants and prevent them from falling and causing "bottoming out". I think you have two options to help the bottoming out. A capsulorraphy is an internal procedure that lifts the breasts without any extra scars. You might be able to achieve more upper breast fullness with this technique. If you stay with the same size, you can also consider using a mesh or "matrix" to support the implants. I bring these points up since you are already going to be under anesthesia for the synmastia repair. Have a discussion with your surgeon to see if he thinks these procedures might be beneficial for you.
So again, I think you can drive, but I think lifting heavy things is not a good idea until 6 weeks after surgery. Have a discussion with your surgeon and follow his instructions to insure a successful outcome.
Good luck.

Richard Baxter, MD · Answer

There are different options for repair of symmastia but with large implants it will likely involve reinforcement with mesh (GalaFLEX) or ADM (Strattice.) The implant diameter is a concern also. A month is usually OK for recovery but you will get the best advice from your own surgeon.

Evan Sorokin, MD · Answer

A month is a good amount of recovery time but not only are they touching in the middle they are too low.  I would highly suggest discussing the possibility of using a support matrix such as gala flex or alloderm to give extra support to your clearly very thin tissue in hopes that this does not recur.  Good luck!

Steven Wallach, MD · Answer

While you may have a component of symmastia,. you rally have severe bottoming out which needs to be repaired. You might want to now with smaller implants as well.

Steven M. Camp, MD · Answer

Thanks for sharing your photos and concerns.  In my practice I have seen patients that develop implant malposition similar to your case referred to me for correction.  I would agree that you have some degree of symmastia, and also significant inferior malposition (bottoming out).  I would suggest an implant exchange and support of your stretched out tissue with an acellular dermal matrix.  Visit with a board certified plastic surgeon that can clearly explain your plan to you.  You should be doing fairly well within 2 weeks and with appropriate activity modification and restriction you should go on to heal nicely.  Discuss your timeline carefully with your surgeon to make sure you have the right expectations.Best Wishe

Tom J. Pousti, MD · Answer

I am sorry to hear about your concerns after breast surgery.  In my opinion, you will benefit from correctional medial breast implant position as well as from correctional "bottoming out" of breast implants.    Keep in mind, that these types of revisionary breast operations to require significant experience when it comes to achieving successful outcomes.  
In my practice, having used a variety of “techniques” for correction of symmastia, I find that the most reliable technique involves a 2 layer capsulorrhaphy (internal suture repair of the breast implant pockets along the cleavage area). Often, the use of acellular dermal matrix is helpful also. I have also been pleased with the (at least partial) correction of skin tenting that can be achieved with the use of the acellular dermal matrix.
 I also find that careful attention to postoperative activity restrictions is key to success with this type of surgery and other types of implant malposition revisionary breast surgery.  Activity restrictions are individualized patient by patient, depending on exactly what was found and done during the procedure.  For example, for most of my symmastia  patients, I ask that they avoid pec major related exercises ( especially exercises that involve abduction of their arms) for at least three months after the procedure is performed.
My best advice: select your plastic surgeon carefully. Make sure that he/she has significant experience achieving the types of outcomes you will be pleased with. Then, communicate your goals carefully. Working together you will come up with a good plan to achieve your goals.  He/she will review necessary postoperative restrictions with you.
 Best wishes for an outcome that you will be very pleased with.

How long will breast aug symmastia reconstruction recovery take? (photo)

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