Symmastia Repair with Reconstruction- Not a breast augmentation

[Jazzygirl]

Hi Dr Pellitiere,
In another Post about fixing Symmastia You said this:
"You should always use permanent sutures in a symmastia repair - why take the chance of having a suture dissolve and release some of the repair. In terms of the folds, they can be altered at the time of surgery as well. Depending on what may need to be done, it can be as simple as suturing or as complex as reinforcing with Alloderm or Strattice. I always change the pocket if possible. If the implants are subglandular, they are going submuscular. If they are submuscular, sometimes if someone has enough breast tissue, they go subglandular. Alot of times, I actually create a neopocket between the scar tissue capsule and the muscle itself. This way, it is a new pocket but still under the muscle. The old pocket is completely closed off and the medial area is usually reinforced with some type of biologic material (Alloderm or Strattice). The implants are almost always downsized as well to take pressure off of the repair areas, since this is usually why someone has developed symmastia - too large of implants for the space, putting pressure medially and wearing through an already weakened area. "

I have Symmastia from a Bilateral Mastectomy Reconstruction.
Would you repair this differently then a breast augmentation Symmastia?
And how would you go about Repairing this?

Thanks for your time.
JazzyGirl

[Dr. Pelletiere]

Unfortunately, your situation is more common then symmastia in augmentation patients. But, the repair techniques are the same. Usually you cannot change the pocket since there is very little tissue to work with. However, repairing the medial areas with permanent sutures, reinforcing with alloderm or strattice, and changing to a smaller or narrow profile implant all come into play. Feel free to send pics to the office email if you want me to take a look and give you an opinion. I hope this helps.

[Jazzygirl]

Thank you Dr Pelletiere.
I will email you pictures.
I need to take new ones.
I once had a Link showing how to take Symmastia Pictures...I cant find it anymore.
How should I be taking these pictures to send to you?

Jazz

[Dr. Pelletiere]

The best way to take photos is to take some from the front, both sides, breasts pushed together, breasts apart, etc. The more angles, the better. It also helps to decrease the size of the photos if possible to around 1000 x 800 or so, otherwise they can take a while to download. Other useful info - when and how many surgeries, implant size, type/ style, etc.