Tom J. Pousti, MD - San Diego, CA Plastic Surgeon

Plastic Surgeons: California: San Diego & Temecula: Tom J. Pousti, MD, FACS

www.poustiplasticsurgery.com

Case of the Week #4

Symmastia Correction Surgery

This 21 year old patient from Bonita, California had her first breast augmentation performed in Tijuana, Mexico about 2 years ago by a surgeon that was recommended to her by her friend. This surgeon in Tijuana, Mexico placed drains in the patient's breasts after breast augmentation surgery (this is not standard practice). Two months after having her breast augmentation, the patient noticed that she had developed symmastia (the implants were touching down the mid-line). She had a "uni-boob" as some would call it. Notice that the patient no longer has "cleavage". The patient's nipple-areola look displaced to each side. The implants have also "bottomed out".

The patient was extremely upset about the results and worried about having revisionary surgery to correct her symmastia. She wanted to make sure that this time she went to a board certified Plastic Surgeon with some experience in symmastia repair.

She found San Diego Plastic Surgeon, Dr. Tom Pousti through a friend and came in for a consultation. She was impressed by the amount of time that Dr. Pousti spent with her explaining how the revisionary surgery would proceed. Dr. Pousti explained that he uses an "internal suture" technique therefore leaving no additional scars on the outside of the breasts. She was shown pictures of other patients who also had symmastia repair performed by Dr. Pousti.

This patient proceeded with revisionary surgery 2 months after her first consultation with San Diego plastic surgeon, Dr. Tom Pousti. Her surgery took about 2 hours with a lot of time and care taken to make sure that we achieved her goals. After her current implants were removed, Dr. Pousti placed internal sutures to reattach the skin to the chest wall and then placed her new implants under the pectoralis muscle. She has smooth, round, saline filled implants placed under the muscle. She has a 390cc saline implant placed on the right and a 420cc saline implant placed on the left.

IN THE OPERATING ROOM:

The right breast has been corrected Both breasts have been corrected

RECOVERY:

2-3 days after symmastia correction:
swelling and bruising One month after symmastia correction

During the recovery period, this patient had to wear a special bra called a "thong bra" to help stabilize the area in between the implants where the internal sutures were placed. After taking care to avoid the heavy lifting for the first 4-6 weeks, her recovery proceeded smoothly and she is very happy with her results.

The first week, you will see bruising and swelling due to the work performed creating the "pocket" for the implant. The internal sutures connect the skin to the sternal wall therefore not allowing the implants to "communicate" with each other. Performing the internal suture technique allows the patient to achieve the results with no additional scarring on the outside of the breasts. Notice the development of a cleavage area, correct positioning of the nipple-areola complexes and correction of the "bottoming out" condition.

Before Surgery:
Symmastia Correction One month after:
Patient is very happy

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