Can permanent sutures for symmastia repair be removed? Where are they typically placed?

Question

Updated: I had submuscular implants put in and over the course of a year developed symmastia. I then had a symmastia repair where only permanent internal stitches were used, no mesh. Now it is 6 years later and I am explanting due to autoimmune disease and want to know if it is possible to get the permanent internal sutures used for symmastia repair removed during my explant and lift. Is that possible or will the dr searching around for them inside cause the skin to detach from the chest wall again? Where are internal sutures for symmastia repair typically placed? And typically how many? When the implant is taken out of the pocket, will the sutures be visible?

Gary M. Horndeski, MD · Answer

Yes, permanent sutures placed at the time of symmastia repair can be removed and you will not have any adverse effects afterwards.  If you are undergoing explant then I recommend a simultaneous lift.  The technique I recommend explantation and lift using The Bellesoma Method.  The implants are removed, your breast tissue is reshaped creating upper pole fullness, elevated higher on the chest wall and more medial to increase your cleavage.  Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained if not injured during your previous surgery.

Best Wishes,

Gary Horndeski, M.D.

Shaher W. Khan, MD · Answer

Hello, thank you for your question. Symmastia repair is a complex surgery that involves repositioning the breasts to correct the condition where the breast tissue merges across the midline, often due to implants. Permanent sutures are sometimes used to hold the tissues in place after the repair, and I understand your concerns about the potential for these sutures to be removed during your explant surgery. Please see the attached video to answer your question. While permanent sutures from symmastia repair can be removed during explant surgery, whether or not they should be removed will depend on how well the tissue has healed and the surgeon's assessment of the repair. Your surgeon will likely take great care to ensure the repair remains intact and that no damage occurs to the chest wall during the process. Be sure to discuss your concerns in detail with your surgeon to create a plan tailored to your situation.

Dallas Buchanan, MD · Answer

Thank you for your question. I would say that any permanent sutures in place could be removed at the time of surgery. But the point of using a permanent suture is to provide long term strength or support. So once those sutures are removed, you are relying on residual scar tissue in the area to hold things together and there is no assurance that will be enough. There is no "typical" amount or placement of sutures as every physician has his or her own preference for what they do and what works in their hands. It would be best to obtain a copy of the operative report for review by your new surgeon. In the end, my biggest question is, why do the sutures need to be removed? Generally speaking, permanent sutures are made of materials that do not generate any inflammatory response (like a dissolvable suture) because they are made of inert material, so I do not think they need to be removed.
Hope this helps!
Dallas Buchanan, MD
VIVIFY plastic surgery
Tampa, FL

Camille Cash, MD · Answer

Permanent sutures are not typically removed during explant.  Your surgeon may be able to remove them if they are easily accessible, otherwise there is a risk that greater damage will be done in searching for them.  I encourage you to discuss your concerns with your surgeon for further understanding.

Gerald Minniti, MD, FACS · Answer

The only evidence we have regarding the relationship of silicone gel breast implants and autoimmune disease is that there is no connection whatsoever. You do not need to remove your implants; it will have no impact on your illness. From the line of your questioning, it sounds like you've been reading misleading information about getting all the scar our and anything that may be harboring 'toxic' substances like the suture. This is wholly unnecessary. Reconsider keeping your implants, they are not the source of your autoimmune disease nor will they ever cause you any other disease.

Can permanent sutures for symmastia repair be removed? Where are they typically placed?

Answers (7)

Answer: Permanent sutures

Answer: Permanent sutures

Answer: Auto-immune disease

Answer: Auto-immune disease

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Everything you need to know about Breast Implant Removal

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Can permanent sutures for symmastia repair be removed? Where are they typically placed?

Answers (7)

Answer: Permanent sutures

Answer: Permanent sutures

Answer: Auto-immune disease

Answer: Auto-immune disease

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Recommended reading

Everything you need to know about Breast Implant Removal

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