BA 3 months post-op: Symmastia repair. (photos)
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Doctor Answers 5
Hi. Sorry to hear about your issues. Are your implants over or under the muscle?
In general, one can use a suture-repair method (capsule plication) to close down the open space. This works if the tissues are in decent shape, and can hold the sutures. Otherwise, some reinforcement of the area may be required, either with Strattice or Galaflex mesh. Downsizing overly wide implants is also helpful to reduce the tension on the repair area.
If there is no one in your town in MN that does this, you might want to speak to a PS at a university center elsewhere in the state.
Correction of symmastia requires experience
You are correct to be doing some research before selecting a surgeon to correct your symmastia. It will be very important to know if the implants are over or under the muscle, and what the dimensions of the implants are relative to the base diameter of the breasts. In some cases the use of internal support with Strattice or Galaflex mesh is needed. The judgment to sort all this out requires experience because a failed repair is even more difficult to fix.
I am sorry to hear about the complication you have experienced. Successful correction of symmastia, in my opinion does require some experience; I would suggest that you do your due diligence when it comes to selecting your surgeon for this type of revisionary breast surgery. Ask to see lots of examples of his/her work helping patients in your situation.
In my practice, having used a variety of “techniques” for correction of symmastia, I find that the most reliable technique involves capsulorrhaphy ( internal suture repair of the breast implant pockets along the cleavage area). Sometimes, the use of acellular dermal matrix ( and more recently biosynthetic “mesh") may be helpful also, in some cases where the tissues are very thin. Often, it is necessary to “open” the breast implant pocket laterally (outer breast fold) to allow for positioning of the implant centrally behind the breast mound. This maneuver may also decrease the amount of implant pressure against the medial suture line. These maneuvers also serve to better position the nipple/areola complexes, centered on the breast mounds.
You may find the attached link (dedicated to symmastia corrective surgery) helpful to you as you learn more about the options available.
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I am sorry that you are having problems with your augmentation. Symmastia occurs because of over-dissection in the medial breast. Correction can be challenging, but there are techniques that have very high success rates. I have performed a number of these procedures before with great results, most commonly using a technique called a " Neo-subpectoral pocket". (see article below, written by my former chairman)
I'd be happy to discuss this further with you, either via email or by phone, if you like.
Thanks for the photos and I'm sorry that this happened to you. I am located in Mill Valley just north of San Francisco. Although I am new to practice, I did additional training just in aesthetic surgery and have done cases just like your before. This is a tough problem to fix, but it can definitely be improved. I would love to try and help you if you're interested.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.