Mild Symmastia? Does It Look Like Another Revision is Needed? (photo)

Hello,

I am sorry for your persistent problems with your implants overriding the midline (symmastia). Although this is a complex issue, the way I am interpreting your question is: Do my breasts look too close together?  My answer is yes, both subjectively ( I do not like this look for my patients), and objectively (your right breast implant looks to be past the midline of your sternum, and your right implant is too far out over the sternum).

Capsulorrhaphy is an excellent technique for reshaping the implant pocket which in turn repositions the implant. However, for symmastia issues, this technique does not work as well as another one, which entails making a new submuscular pocket (neo-submuscular pocket) by collapsing and sewing closed the old pocket. Additionally, your repair was bound for failure due to the inappropriately large implants for your chest dimensions, and the use of high profile implants which push the skin envelope away from your sternum more aggressively.

Although others might disagree, I think if you want to get serious about fixing this problem, you will need to let go of your original aesthetic goals of breast augmentation, and allow an expert revision breast surgeon to remove your current implants, definitively repair the pockets, and replace with implants that are both narrower in diameter and lower profile (roughly a 150 cc reduction). Although I am sure you've already spent a lot of money, this is no time to look for the cheapest prices; that will only lead you back to wear you are now.

Best of luck.

Thank you for your question and photos.  It is not clear if the photo on the left is you after your latest revision.  In any event, you have a very narrow distance between the breasts, but not true symmastia.  The basic tenants for repair of this problem is to down size the implants and then use a combination of techniques with suture and/or a biologic tissue (Strattice) to help support the implant medially to prevent it from migrating over.  This is a difficult revision surgery and can be troubled by recurrence of the original problem (implant being too far medially).  Best to have your surgeon evaluate you and the two of you can determine if another revision needs to be done

Best of luck.