Best Option for Mild Symmastia/Bottoming out Repair?

Hi, I have 700cc sub-pectoral, mod-plus smooth round silicone. Flat chested pre-op. Early 20s, no kids. Bottoming out (R) and mild symmastia. Should I explant with internal bra for repairs, then wait one year for tissue shrinkage/healing before placing a smaller implant (around 350cc). Will I be able to go back under muscle? Should I have repairs and implant replacement at once...(450cc is smallest i have been told i can go). I would address lift later on. What should I do?

Doctor Answers 5

Synmastia and Bottoming Out Repair

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Without a physical exam, I am guessing that your large 700cc implants are likely contributing to your "mild synmastia" and bottoming out.  Downsizing your implants with internal repair techniques to control your pockets will help achieve your goals.  Depending on the severity of your synmastia and bottoming out, I may recommend use of a dermal matrix product (collagen sheet) known as strattice to help reconstruct/re-define your pocket.  I do not think you need to undergo an implant removal.  Please see a board certified plastic surgeon to learn more about your options.  Best wishes!

Dr. Basu

Houston, TX

Best Option for Mild Symmastia/Bottoming out Repair?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Although specific advice would necessitate in person evaluation, most patients who present with breast implant displacement concerns in my practice, benefit from internal suture repair of the breast implant capsules (capsulorraphy). Most of the time, in my practice, these procedures are done in a single stage without the necessity of removing the breast implants. You will find the attached link, demonstrating many examples of similar situations, helpful to you. Best wishes.

Symmastia and large implants

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

It sounds like from your description that your implants are probably too large. It is difficult to answer your concerns without an exam. 

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

#BreastImplant Malposition and Bottoming Out with Large Implants

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

From your description, it is likely that the oversized implant is contributing to your issues. Downsizing with internal repair would be the normal course, but waiting a year without an implant isn't necessarily needed. Without photos or an exam, it is impossible to tell you more, but it is likely that you will be very unhappy with the cosmetic result after removing 700 cc and not replacing an implant. 

Best of luck,

Vincent Marin, MD
San Diego Plastic Surgeon

Vincent P. Marin, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 52 reviews

Would I Need a Capsulorraphy

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

The key is to go with a smaller implant.

Without at least photos, iI am very reluctant to offer a suggestion. I think you are best taking the suggestion of your surgeon, hopefully one experienced with these issues. If you can add some photos to your question, you may get more useful responses.

Thanks and best wishes. 



Jourdan Gottlieb, MD
Seattle Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.