This last and successful revision surgery was performed by Dr. Thomas DeWire
Immediately after my breast augmentation (in March 99) there was a raised area between my breasts which gradually got worse. I had a surgery 8 months later to correct it. It did not take. The first picture is pre-op. The second picture is how I looked after surgery. The third picture is immediately after my first redo, which did not work. Finally, the fourth picture is how I look now, despite corrective surgery. I am looking for the right surgeon to have it corrected the right way.
Note: This condition can occur in women who undergo submuscular breast augmentation when the muscle that is attached to the sternum and goes horizontally across the implants has been cut by the surgeon. When this occurs, everything can appear fine immediately after surgery. Within a few days, however, the pressure of post-operative swelling forces the implant to move and since the muscle that would hold the implant or implants away from the cleavage area has been cut, the implants move toward the center. As a result of the pressure the tissue can lift from the sternum and allow the implants to move into the center, causing the appearance of one large implant across the chest (hence the term "breadloafing").
Repair: To repair symmastia, the implants will be removed, typically through a crease incision and corrective work needs to be done and it should be done on the inside. If your doctor recommends external sutures (see photos), please consult a second plastic surgeon. External sutures, which involve sutures from the outside and down into the sternum, will cause additional and significant scarring in the cleavage area and the chances of the external repair being successful are minimal.
The correct repair of symmastia is an internal repair. The surgeon will cut scar tissue out of the cleavage area and roll it back into the pocket. These "rolls" will give the surgeon something to put permanent sutures into and the thickness of the rolls will give strength.
Below is a drawing submitted to us by a patient with symmastia and who is awaiting corrective surgery. The x's represent sutures. The surgeon will reattach the muscle with a row of permanent sutures. Then, the surgeon will put a row of permanent sutures in the cleavage area running down the side of each breast, curving at the bottom to make it look as natural as possible. Then, the surgeon will put a row of dissolvable sutures on each side of the cleavage. This will help to hold the cleavage down until the raw surfaces have time to heal together. This can cause the skin to pucker, but when the stitches dissolve, the skin smoothes back out. Then the implants are placed back in and the bottom of the breast is resutured.
After corrective surgery, your surgeon may recommend wearing the "Thong Bra" for at least two months to help apply pressure and keep the area stable until everything has time to heal. (T back sports bra worn backwards).
The patient featured above had this to say about her condition and the apparently incorrect repair that was done:
"My redo picture shows exactly how the surgery should NOT be done. I think it is important for women to know that if their doctor describes putting external sutures in, they should find a new doctor. My condition is worse now, and I have scars between my breasts. I've paid $6,000 total for this plus time off of work. I haven't been able to wear the triangle top bikini I've always dreamed about. In fact, I can't even wear normal tank tops or V-necks anymore because this is VERY obvious. I won't even let my fiancé see me topless. This has been a very difficult 10 months. Just when i though all my insecurities about me chest were going to vanish...they got about 1000 times worse.
Thank you so much for adding the "augmentation problems" part to the website. I felt so alone until 2 women with Symmastia finally responded to my posts on the forum, the chances of finding them were almost nothing. This area of the website will give comfort to many women knowing they are not alone.
The last picture on the right is the 2 month post-op view after this patient's correct repair with Dr. DeWire from Virginia.
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