This 41 year old patient from Arizona had breast augmentation surgery in 1992 and again in 2002 by a previous surgeon in her home town. The patient developed symmastia, also know as ‘bread loafing’. Symmastia occurs when two implants touch one another in the center of the chest. 8 years later she decided to proceed with revisionary breast surgery to correct her symmastia and to add volume to her breasts. The patient found Dr. Pousti online and ultimately decided he was worth the travel to San Diego, California due to his experience with breast reconstruction surgery.
The patient met with Dr. Pousti and his staff the day before surgery in his office. The entire breast revision procedure was reviewed in detail with the patient and markings were made.
The red arrows indicate where the patient desires more fullness and the red portion that is colored in the middle is where the symmastia repair will take place.
Once the patient is in the operating room she is placed in an upright position and her measurements and markings are re-checked.
After implants are removed the symmastia repair portion of the surgery is performed. In order to correct this patient’s implant malposition Dr. Pousti used internal sutures to re-attach the muscle back to the sternum. This is also knows as ‘pocket correction’. Once symmastia repair is completed sizers are used to determine the size of implant needed to achieve the patient’s size goals. To achieve this patient’s desired look a 800cc Saline implant overfilled to 920 was used in her right breast and a 800cc saline implant overfilled to 820 was used in her left.
If the horizontal muscle that is connected to the sternum and goes across the implant is cut during surgery, then the implant can move toward the middle of the chest. This is more noticeable when the patient is in the prone (laying down) position.
Before
Immediately After Surgery
Bolster dressing is placed immediately after and is to be worn along with a ‘thong bra’ for 1 month to stabilize the area and help prevent symmastia occurrence.
The patient is extremely pleased with her initial results.