What options do I have to get rid of my symmastia? (Photo)

First operation 520cc over muscle high profile ended up with symmastia ,2nd op to correct it with 470cc over extra high profile with repair to centre and I still have this problem? What can I do...

Doctor Answers 3

Polyurethane implants might help

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Dear Laura,  I am sorry to hear about your problems. Symmastia is a difficult problem to correct, as you have discovered.  My first thought would be to consider polyurethane foam implants as these do tend to stay where you put them and can be helpful in cases of symmastia.  It may also be necessary to use a biological mesh to keep the implant pockets separate.

This is difficult surgery and can be expensive I am afraid.  Look for a fully trained plastic surgeon, preferably one that specialises in breast surgery.  Look for the letters FRCS(Plast) after their name - BAPRAS and BAAPS are the plastic surgery associations and they have lists of their members on the websites.  If you can find someone who is or has been a consultant in the NHS, with a practice dealing in breast reconstruction, they may be best suited to help you.  Good luck.

What options do I have to get rid of my synmastia

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Thank you for your question and I am sorry to hear of your implant malposition issue.  Unfortunately your photograph did not load appropriately to be able to see your current appearance, but in general to fix synmastia patients benefit in reducing the width of their implant to reduce the pressure placed on the synmastia repair and surrounding tissues.  The synmastia repair then can be achieved either with the use of sutures or sutures with an added layer of mesh support.  Be sure to see a board certified plastic surgeon in consultation 

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 80 reviews

What options do I have to get rid of my symmastia?

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Thank you for your question.
Symmastia (or medial malposition or “uni-boob”) occurs when the breast implants move too far toward the midline--the two implants may actually touch one another in the center of the chest. If the horizontal muscle that is connected to the sternum and goes across the implant is cut during surgery, then the implant can move toward the middle of the chest.
Symmastia may result from overly aggressive attempts to alter chest wall anatomy trying to increase cleavage for patients. This outcome is made worse by use of larger implants in thin patients, and is a problem for implants over or under the muscle, though sub muscular implant placement allows the muscle to provide some softening of the transition to the cleavage area from the augmented breast mound.  

In my practice, having used a variety of “techniques” for correction of symmastia, I find that the most reliable technique involves a 2 layer capsulorrhaphy (internal suture repair of the breast implant pockets along the cleavage area). Often, the use of acellular dermal matrix is helpful also. I have also been pleased with the (at least partial) correction of skin tenting that can be achieved with the use of the acellular dermal matrix.

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. Use of a smaller breast implant, if possible, may serve the same purpose.
Correction of implant malposition issues does require some experience; make sure your plastic surgeon can demonstrate his/her experience level. I hope this, and the attached link/video, helps.
Best wishes.

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