Implant is too close to midline and I have crooked cleavage (one breast reduced in implant/pocket size). Undo sutured pocket or switch implant?
I recently (6 month PO) had one breast reduced due to asymmetry. The left implant was reduced in size and had a pocket revision. Now that the implant has settled, the implant is too close to my midline (goes past midline with bra on) and I have crooked cleavage. Would it be better to undo the pocket revision or switch to a narrower/smaller implant (left is still larger). I worry smaller implant (as my doctor suggested to avoid undermining the pocket) will not fix the problem entirely.
Answers from doctors (3)
Thank you for your question. Unfortunately, what you are describing is a synmastia with medial implant displacement. Your plastic surgeon is correct, a narrower base implant will improve the asymmetry and implant position. In situations like yours, I also recommend repairing the medial segment of the breast implant pocket with a capsulorrphapy or plication. Additionally, if your breast tissue is thin or weak you may require more soft tissue support with either an absorbable mesh (Galaflex) or acellular dermal matrix (Alloderm, Strattice, Belladerm). Postoperatively, a support bra designed to keep the breasts separated in the midline is recommended as well. Good luck and I hope everything works out for you.
Published on Jul 11, 2012
It sounds like you may have a relatively rare complication of breast augmentation know as "symmastia" also known as "uni boob." It can occur when the pocket is dissected to close to the midline. The good news is that it is fixable and there are several approaches to correction. Closure of the pocket with sutures +/- reinforcement material (ie ADM), creation of a new fresh pocket (subglandular to subpectoral or vice versa) and implant replacement with smaller diameter +/- textured surface implants are all possibilities. You should consult with your plastic surgeon regarding your options.
Published on Jul 11, 2012
Probably the only way to fix or help this problem would be to create a whole new space so the uniboob is no longer an issue.
Dr. Edward Jonas Domanskis is Certified by the American Board of Plastic Surgery
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Assistant Clinical Professor of SurgeryWOS-Plastic,University of California (Irvine)
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Plastic Surgery- 2005-2017
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Published on Jul 11, 2012
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