Are symmastia repairs effective?

Question

I have 340cc ultra high profile silicone implants placed above the muscle. One implant now sits over the center of my chest and touches the edge of the other implant. What is the surgical fix for this and is it effective? What is the recurrence rate? I am considering explanting if the repair is not effective or has a rate of recurrence as I am less than 6 months post op from my first BA and do not want to undergo surgery after surgery to fix the problem.

Richard Baxter, MD · Answer

There are several things to consider for successful repair of symmastia:
1. Make sure the implants are not too wide for the natural base diameter of your breasts. This may require downsizing since you already have ultra high profile implants.
2. Under muscle placement creates a natural boundary to the pocket which helps minimize the risk of symmastia, so consider going under muscle.
3. An internal bra with Galaflex mesh can also help define the boundary of the implant pocket.

Paul E. Chasan, MD, FACS · Answer

Thank you for your question.  A large portion of my practice is dedicated to breast revision.  The usual correction for symmastia is very effective which includes suturing the pocket-capsulorrhaphy.  I wrote the first paper on this 1999.  I do see a high rate of pocket malposition and poor results after subglandular placement of implants.  In your case, I would reposition the implants in the subpectoral location and also perform a doughnut repositioning of your areolas more centrally as they fall to the side.  Best wishes to you.

Daniel Barrett, MD · Answer

Dear nkmay,
breast revision surgery is the most difficult plastic surgery procedure performed. Botched breast surgery alters normal tissue planes and laxity, the ability of breasts to heal properly, and leaves scar tissue that dramatically affects the level of difficulty of the corrective surgery.Many patients come in to correct poor outcomes from their initial surgeries. The most common problems are due to implant malposition, bottoming out of the implant, poor scarring, and incorrect implant size.While the type of revision required will depend on the result of the previous surgery and the desired result of the patient, some revisions involve extensive pocket repair that may or may not need specialized external bras.If you are considering breast surgery revision, you should speak with a board certified plastic surgeon and have yourself properly assessed. Only after a thorough examination you will get more information and recommendations. Also, you have to make sure that your surgeon understands your breast augmentation goals.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Connie Hiers, MD, FACS · Answer

Your implants are too large for your frame. If you go smaller, this symmastia can be repaired at the same time.

Are symmastia repairs effective?

Answers (4)