Can I get symmastia repair with only permanent sutures and no mesh?

The treatment is very difficult and involves suturing the pectoral fibers back to the chest wall with or without acellular dermal matrices such as Alloderm or Strattice. The implant size will likely need to be reduced as well to eliminate pressure on the repair.

If your surgeon can repair the symmastia with internal sutures, then go with his/her advice. Your surgeon has examined you and will be the best one to tell you what is needed.

Symmastia is a difficult problem to correct in plastic surgery. There is not a consensus way to fix the problem so 10 plastic surgeons will probably give you 10 different ways to fix it - and all may work well. I personally prefer to use a mesh when fixing symmastia. You best bet is to ask you surgeon to provide you some photographs of previous patients with similar issues. Ideally, the post operative pictures would be a year or more after surgery.