Case Number 529: Symmastia Repair – Breast Reconstruction Surgery

This 21-year-old patient from Bonita, California came to see Dr. Pousti for revisionary surgery. She had gone to Mexico for her breast augmentation surgery (performed by another Surgeon). Due to “bottoming out” and symmastia the patient was unhappy with the results of her surgery.

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 and goes across the implant 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 from the augmented breast mound.

The patient researched for an experienced Board Certified Plastic and Reconstructive Surgeon to help her with her complex case. Her friend, who is a patient, referred her to Dr. Pousti, and after looking through numerous successful breast revision surgery performed by Dr. Pousti, the patient knew Dr. Pousti was the best surgeon for her and scheduled for surgery.

The risk and complications were reviewed and markings were made in detail the night before surgery.

(Intra-Operative) Internal sutures were used to to create in “internal bra” for the new positions of the implants

Before

After 2 years

Before

After 2 years

Before

After 2 years

Before

After

Before

After

Before

2-3 days post-op symmastia repair

During surgery, one side repaired

In the operating room

Before

After

After 4 months

After 4 months

Patient Testimonial: 

Dear Dr. Pousti and Staff, First off I want to thank you guys, you are all wonderful. Dr. Pousti I came to you after two years of living with symmastia with very little hope. When I meet with you the first time I felt so comfortable and you gave me hope. I knew you where the one to trust. I m so thankful I found you. You exceeded my expectations. You changed my life. Thank you so much for the beautiful space between my breasts. They look awesome. To your staff you guys are so sweet and friendly I feel like I have known you guys for years. Vanessa thank you for your support you have been a great friend.

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