Symmastia - Will A Capsulorraphy And Sutures Alone Correct This Problem?
Symmastia is a complication of breast augmentation when one or both implants cross the midline and make it appear that you have only one breast. The correction of this problem requires the re-establishment of the natural cleavage.
Your plastic surgeon used the tried and true method of utilizing your scar capsule plus sutures to re-establish the medial boundary of your breast implant pocket. This technique has a history of long term success. In my practice, as an adjunct to the capsulorraphy, I usually place Seri scaffolding to increase the likelihood of a long term repair.
I believe you are very fortunate your plastic surgeon did not use Strattice. I and other plastic surgeons have noted that Strattice has a tendency to do such a good job of inhibiting the formation of a scar capsule around an implant that, at times, good solid suture repairs dissolve.
The short answer to your question is statistically, your symmastia surgery should hold.
Thank you for your question though it is really impossible to say what will happen in the future.
Assuming your surgeon is an expert in the field you should do very well though.
Will my symmastia repair hold?
Assuming you have chosen your plastic surgeon carefully, based on significant demonstrable experience with this type of revisionary breast surgery, it is most likely that your repair will be successful. In my practice, the majority of patients we help with this situation benefit from capsulorraphy surgery, similar to what you have described. A smaller percentage of patients benefit from the use of additional support materials such as acellular dermal matrix or biosynthetic mesh. I hope this, and the attached link (dedicated to symmastia surgery) helps. Best wishes for an outcome that you will be pleased with long-term.
If your Plastic Surgeon is a reputable, board certified and experienced Plastic Surgeon then you've done the best you can. You should expect to heal well and have the lowest possible risk of complications.
All the best
Symmastia repair- only time will tell
Using the existing capsule and sutures to aid in the repair as well as Strattice are both acceptable techniques- both with advantages and disadvantages. True rejection of strattice is rare, but you could have failure of the graft to become incorporated into your own tissues, migration of the graft, infection as well as seroma formation. It does provide the advantage of strong tissue for support though. Only time will tell how the repair will hold up. Best wishes.
Will my symmastia repair hold?
Using the old capsule (especially if several years have passed and a nice capsule has formed) along with both absorbable and non-absorbable sutures should work very well. Follow his advice for post op care and activity very closely as this is one type of surgery that is very dependent upon the compliance of the patient. Take care and good luck.
This technique is a great standard, it has work well for years. I suggest you follow his instructions carefully and completely, report and changes he should know about.
Stephen M. Dvais, MD, FACS
Green Hills Plastic Surgeron
Your PS used a traditional method to repair symmastia that is tried and proven and with good technique it will hold if you follow the post op protocol and give the repair good support 24/7 for 3 to 6 months in my experience. Mesh like support structures have been used with success but are not necessary in all cases for a successful outcome. Best of luck!