| This 44-year old patient from Santa Barbara, California (Northern California) found Dr. Pousti while researching for a surgeon who is Board Certified in Plastic and Reconstructive Surgery on the Internet.
The patient previously had breast augmentation surgery in the mid 80s with silicone implants, then breast implant revision surgery in the mid 90s to replace her silicone implants with saline implants due to capsular contracture. The symmastia developed thereafter. After several phone calls and e-mail consultations, the patient decided to come to San Diego to meet with Dr. Pousti.
Symmastia - commonly referred to as “bread loafing” or “uni-boob”, occurs when two implants touch one another in the center of the chest. If the horizontal muscle that is connected to the sternum is cut during surgery, then the implant can move toward the middle of the chest. Symmastia results from overly aggressive attempts to alter chest wall anatomy trying to increase cleavage in 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 submuscular implant placement allows the muscle to provide some softening of the transition to the cleavage area.
In addition to the symmastia, the patient described she had a tight tendon that shows through the skin on the left and “something” underneath one of her breasts that looks like an indentation from the scar from her second breast . The patient also said, she remembered her previous surgeon telling her, he had “cut” something to improve cleavage. Since then the patient has had rippling, and when lifting weights, the patient can see her chest wall pulling against the implants.
After speaking with Dr. Pousti, she felt very comfortable proceeding with revisionary breast surgery. After seeing the results that Dr. Pousti has achieved for other patients in the same situation, this patient decided to proceed with revisionary breast augmentation surgery and symmastia repair. One of the more common problems that patients are seeking Dr. Pousti’s help for is symmastia.
After discussing the risks and complications of surgery, the patient scheduled for surgery.
Markings were made carefully prior to surgery. The “red” markings are where the internal sutures will be placed to separate the 2 breasts.
You can see here that when the two breasts are pushed together, they become one breast — there is no separation. This is what Dr. Pousti will correct with the internal sutures.
Due to very little breast tissue and thin skin, Dr. Pousti used AlloDerm to serves as an addition to the adjoining soft tissue on the chest, allowing for more coverage.
Her previous saline breast implants were removed.
After surgery, when pressure was placed on the outside of the breasts, the implants stayed separate.
New 492cc silicone-gel filled breast implants were used in both breasts with submuscular placement.
Before
After Patient sent this picture via e-mailPatient Testimonial:My experiece with Dr. Pousti and his office has been excellent. I couldn't be happier with my results. I am currently 14 days post op and feel great. I am back to work and haven't taken pain medication since the first week following surgery. My recovery was much quicker and much less painful than I expected. Dr. Pousti not only repaired the symmastia but also gave me the look that I had requested. I am extremely happy that I had my repair performed by Dr. Pousti only regretful that I didn't do it sooner.
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