What is the Chance of Recurrence of Symmastia?

Question

I am going for a consultation for symmastia revision. I would describe the symmastia as moderate. I do not want an overly large gap between my breasts post-operatively, but I do not want to end up needing a second revision surgery for symmastia. What is the chance of recurrence and what should I discuss with my doctor? My implants are smooth round moderate plus, 510 cc under the muscle.

Tom J. Pousti, MD · Answer

Symmastia (medial malposition breast implants) can be corrected with high likelihood of success (about 90% success rate) is using medial breasts implant pocket sutures  (medial capsulorrhaphy), lateral capsulotomy (if necessary), and/or the use of allograft. I do not believe that a staged procedure, involving removal of implants for period of time, is necessary.

	There is a learning curve with this operation and I recommend that you seek consultation with a board-certified plastic surgeon with significant experience treating this problem. You may find the link attached below helpful.

	Best wishes.

Jed H. Horowitz, MD, FACS · Answer

#Symmastia is a condition which can occur when the implants are too close together. Patients often refer to this as a “uniboob.” Occasionally, 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. Sometimes, 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.

Larry S. Nichter, MD, MS, FACS · Answer

Symmastia is a condition which can occur when the implants are too close together. Patients often refer to this as a “uniboob.” This can occur for the same reasons as displacement noted above, but in this case the pocket(s) is/are too far towards the center.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.

Christopher V. Pelletiere, MD · Answer

There are a few critical things that you need to do to achieve a good, long lasting repair.  First, you need to change the pocket for the implant if possible.  If this is not possible, then you need to reinforce the medial areas with both capsule work and possibly some Alloderm/strattice.  The other thing that needs to be done is to change the implant to a device that is not as wide as your current implant. This may be downsizing the implant, or may be changing to a different profile.  If you do these maneuvers, then the chance of success is high.  However, you really have to be cautious for at least three months and allow the areas to heal and seal off before stressing them.

Brent Moelleken, MD · Answer

At 510 cc, your implants are large.  They project far into the armpit and centrally, to the point that they meet in the middle, synmastia.
Repair of the pockets is a difficult procedure, and not perfect.  The repair can fail, especially if large implants are still present.
Sometimes the best procedure is to remove the implants, downsize or remove them altogether to allow the natural pocket to build strength again before replacing with smaller implants.
Placing the implants above the muscle is also a potential solution which may involve a relatively new pocket, but the patient will have the disadvantages (rippling, palpability, visibility, reduction in blood supply to the nipple) inherent with that approach.
These are technically complex procedures and a great deal of experience with revision breast surgery is a must.

What is the Chance of Recurrence of Symmastia?

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Answer: Symmastia Repair

Answer: Symmastia Repair

Answer: Synmastia repair

Answer: Synmastia repair

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What is the Chance of Recurrence of Symmastia?

Answers (10)

Answer: Symmastia Repair

Answer: Symmastia Repair

Answer: Synmastia repair

Answer: Synmastia repair

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Everything you need to know about Breast Implant Revision

Our mission is to create a world where every investment in modern beauty is Worth It.