Symmastia correction - what could the possible causes of this be? (Photo)

Question

I am 12 months post op breast augmentation with anatomical 330cc dual plane. I am heartbroken with the results. My surgeon has confirmed that my implants are not sitting correctly and suggests that he remove the implants for 6-12 months, conduct internal bra stitching and let me heal before putting new implants in (I have opted for smaller implants!) What could the possible causes of this be? Implant size, wrong positioning, genetics? Is internal bra stitching the best approach?

Gary M. Horndeski, MD · Answer

In your before photograph, your breasts were widely separated. At this time, the large implants have results in your nipples pointing outward. Initially you needed a mini lift to reposition your nipple-areola complex and correct the wide separation. The surgeon placed large implants and dissected too far medially and now you have symmastia. If the implants are retro-pectoral then I recommend implants removal and a mini lift. Using a circumareola incision, the implants are removed, your breast tissue is reshaped, elevated higher on the chest wall and more medial to increase your cleavage. At the same time, fat transfers or small implants can be placed totally submuscular.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Paul E. Chasan, MD, FACS · Answer

Thank you for your question.  Symmastia is a fairly common problem associated with oversized breast implants.  A large portion of my practice is dedicated to revisionary breast surgery.  In fact, I wrote the very first paper on capsulorrhaphy-internal bra which iss the treatment for symmastia.  There is absolutely no reason to remove the implants.  This definitely can be done in one stage and is done by many experienced plastic surgeons around the world. Best wishes to you.

Daniel Barrett, MD · Answer

Dear cheyanneday,
symmastia is a rare breast condition that occurs when soft web-like breast tissue pulls breast implants towards each other, until the breasts meet uncomfortably at the center of the chest near the sternum (the body’s midline point). Given this abnormal union, symmastia is known by many other names, including breadloafing, kissing breast implants, and the uniboob.Unfortunately, this condition causes the surrounding skin and pectoral muscles to literally lift off the breast bone as the implants are pulled together. This consequently causes pain and discomfort, as well as obvious distortion of the breasts, which can only be disguised with clothing that does not show cleavage.You should consult with a board certified plastic surgeon for proper assessment. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Ronald J. Edelson, MD · Answer

Those implants look larger than 330. And I'm not so sure you have synmastia. Consider going with smaller implants

Douglas Taranow, DO, FACOS · Answer

You require smaller implants and the medial portion of your breast pockets to be plicated (sutured) internally.  I usually do this in one procedure.  If the capsule that I suture too is not strong enough, it may be bolstered using ADM (Acellular Dermal Matrix-tissue patch that helps support the plication).
Dr. Taranow

Connie Hiers, MD, FACS · Answer

Your implants are too large for your frame and you need to go down in size with a more narrow base. Your pockets can be tightened as well. You will probably have your best results if done in two stages.

Richard P. Rand, MD, FACS (retired) · Answer

Your photo demonstrates that the implants you have are way to wide in diameter for your frame. They need a much narrower diameter and the result will be less prone to recurrence.

Symmastia correction - what could the possible causes of this be? (Photo)

Answers (7)

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