"I have lose skin in cleavage after downsizing. I have been told I have symmstia and told I do not have symmstia by different surgeons. All board certified. I am confused. I need to know if when you fix symmstia do you use internal sutures in the cleavage area? If you have lateral displacement and symmstia can that be fixed at the same time? Are silicone implants much lighter than saline and better in a revision surgery?"
DR. POUSTI: Symmastia repair: do you sew the skin down to the bone in cleavage? Or do you just hope it reattaches after surgery.
Generally speaking, I utilize permanent sutures along the “cleavage area” when it comes to correction of symmastia. I have found the use of acellular dermal matrix helpful for most patients undergoing this type of surgery. Although some skin “tenting” may persist after this type of revisionary breast surgery, I have been impressed with the degree of skin redraping that occurs. Actually suturing skin down to the sternal bone, in my opinion, can lead to a very unsatisfactory aesthetic outcome. Silicone gel breast implants have some advantages when it comes to potential rippling/palpability; they are slightly lighter in weight than saline implants.
Again, it will be important that you select your plastic surgeon carefully. Best wishes.