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

Question

Can Symmastia be fixed with only permanent sutures and no mesh? Doctor say the mesh will be a waste of money, the most important thing is create a good internal bra with permanent sutures. Please help. Mesh or no mesh? worth it the extra money?

Kenneth Hughes, MD · Answer

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.

Casey Anderson, MD, FACS · Answer

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.

William T. Stoeckel, MD · Answer

Synmastia or symmastia does not always require a mesh for effective correction. If the implant capsule has enough integrity, sutures alone can be very effective. I personally would not suggest a mesh reinforcement unless a previous repair has failed already without mesh.

Donald R. Revis Jr, MD · Answer

Good morning!
Yes indeed- with the Original Internal Bra, my strong permanent internal suturing technique which corrects synmastia. This is the most common revision technique I perform, 5-6 times a week. You do not have to use mesh, but it is available if you want to use it. About 20% of patients choose the mesh option, but it is rarely ever a requirement for surgery.

Zoran Potparic, MD · Answer

In most cases symmastia may be corrected using sutures and local tissue flaps. However, in some cases surgeon has to use a mash to reinforce repair.

Luis A. Mejia, MD · Answer

Hello darling,

I always recommend the mesh since the symmastia could be a really dificult condition to repair with just sutures. It all depends on you and if youre willing to get a second surgery just in case the sutures alone doesnt work.

Make sure you go on consultation with a board-certified plastic surgeon.

Best of lucks!

Dr. Luis Mejia.

Daniel Barrett, MD · Answer

Dear ForeverDiva,
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

Ram Kalus, MD, FACS · Answer

Clearly, a response specifically relevant to your own situation would require an evaluation in person. That said, the repair of synmastia is notoriously unsuccessful with the use of sutures alone. Depending on the quality of your tissue, anatomically the tissues near the sternum are often very thin and the repair is more dependent on the tissue to which you are suturing, than the sutures themselves. Therefore many plastic surgeons, myself included, have found that results are far more predictable and long lasting with the use of either a synthetic or biological material to achieve optimal pocket control for the implant. The width and volume of your implants, as well as a smooth versus textured surface, are important factors to consider. If your chest wall has a slight inclination toward the midline, a smooth surface implant may want to naturally slide inward, and a wider than desirable implant will continuously press against your native tissues forcing them closer together.

Please consult with an experienced board certified plastic surgeon who can advise you on all of your options and hopefully help you achieve the result you are seeking. Best of luck to you.

Please consult with an experienced board certified plastic surgeon who can advise you on all of your options and hopefully help you achieve the result you are seeking. Best of luck to you.

Connie Hiers, MD, FACS · Answer

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.

Andrew Gear, MD · Answer

There are many more modern techniques to repair symmastia that do not rely on mesh.  One I use often us too create a "neopectoral pocket" where the implant is removed from the old pocket, the pocket is closed, and a new, more accurate pocket is create just above the old pocket.  Depending on the severity of the symmastia, it can be reinforced with sutures or an allograft such as Alloderm or Mesomatrix.

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

Answers (12)

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