Risk of symmastia reoccurring after explant, capsulectomy and lift?

Question

I had a symmastia repair after getting implants. 10 permanent sutures were placed on each side. It is my understanding that with the capsulectomy portion of the explant, there is a risk of symmastia reoccurrence because part of the capsule could have been used to do the repair. I also want to know about the risk of symmastia reoccurrence if I have the permanent sutures removed.

Daniel Barrett, MD · Answer

Dear agreenwood4,

I understand your concern. However, without a proper assessment, it would be difficult to determine what is wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Shaher W. Khan, MD · Answer

Hello, thank you for your question. Having had symmastia repair surgery along with implants introduces unique considerations regarding the potential for recurrence of symmastia, especially during the explantation process. Please see the video I have attached to answer your question in detail. The risk of symmastia recurrence after explantation and the removal of permanent sutures is a valid concern. The interplay between the repair sutures, the status of the capsule, and your body's healing response can all influence outcomes. Engaging in a detailed discussion with your plastic surgeon about these aspects is vital for making informed decisions regarding your treatment and ensuring the best possible outcome.

Robert M. Wald, Jr., MD · Answer

The chance of developing symmastia following implant removal, capsulectomy, and breast lift would be small if the surgeon is aware of the previous surgery. The main reason for symmastia is over dissection of the pocket and placement of an implant. Without an implant, there will be no pressure on the muscle and fascial attachments at the sternum.

John L. Burns Jr., MD · Answer

Explant/capsulectomy should not cause recurrent symmastia.  If it does the explant surgeon could place sutures to fix any recurrent symmastia.

Gary M. Horndeski, MD · Answer

Symmastia occurs when implants are present and they cross the midline. Once the implants are removed, there are no implants to cross the midline. Unless you have large amounts of breast tissue that is abnormally positioned. You should not have symmastia after capsulectomy, explant and lift. The lift technique I recommend is The Bellesoma Method. This will reshape your breast tissue 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.

Best Wishes,

Gary Horndeski, M.D.

Ashley Thorburn, MD · Answer

While symmastia (unintended connection of the breast implants across the midline) is typically associated with implant placement, the risk of recurrence after explant, capsulectomy, and lift depends on various factors, including the surgical technique, tissue quality, and individual healing response. Discussing your concerns and medical history with a board-certified plastic surgeon can provide insights into your specific situation. Regular follow-ups and adherence to postoperative care recommendations are crucial in minimizing potential risks.

Connie Hiers, MD, FACS · Answer

The sutures and part of the capsule used to do the repair could be left. Otherwise, a repair may need to be redone and mesh may be needed this time. However, since the implants are being removed, your natural tissue will just remain. If you did not have symmastia naturally, you should not have it once the implants are removed.

Mats Hagstrom, MD (license on probation) · Answer

This condition is primarily related to the projecting force of implants. Removing the implants should have little risk of creating recurrence. I suggest you speak to your plastic surgeon about it.
There are rarely yes or no answers especially your questions asked
I think it’s unlikely you will have recurrent Synmastia

Risk of symmastia reoccurring after explant, capsulectomy and lift?

Answers (8)

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