This 27 year old patient from San Jose, California previously had breast augmentation surgery with a local plastic surgeon. She was unhappy with the results and wanted to find a plastic surgeon that could help correct her symmastia. She met with Dr. Pousti and discussed revisionary breast augmentation surgery with Dr. Pousti and after evaluation, Dr. Pousti recommended capsulorrhaphy as well as the use of Allograft with this patient.
The capsulorrhaphy (internal bra) in performed by placement of 2 layers of permanent sutures in the capsule which has formed around the breast implant to create a new “pocket” for the breast implant and improve the positioning of the breast implants on the chest wall. As you can see above, the nipple/areola complexes are not centered on the breast mound – they are pointing outwards. Once the placement of the implant is corrected, the nipple/areola will be more centered on the breast mound.
Dr.Pousti performs markings and measurements the morning of surgery. He also likes to go over the patient goals and any questions or concerns they may be having before the surgery as well. The shaded “red” are the areas where the internal capsule work will be performed to improve the breast positioning.
ADM has many indications for use; additional coverage, additional support, improve rippling, reduce recurrence of scar tissue formation and more. In this patient’s case, the Acellular Dermal Matrix (ADM) will be used for additional support in the cleavage area to make the internal suture repair as strong as possible for symmastia correction.
Strattice™ Reconstructive Tissue Matrix is an acellular reconstructive tissue matrix designed to support tissue regeneration. It is derived from porcine dermis, which undergoes non-damaging proprietary processing that removes cells and significantly reduces the key component believed to play a major role in the xenogeneic rejection response.
This is the patient directly after surgery. As you can see, the implant positioning as well as the nipple / areola positioning are significantly improved.
She has 300 moderate plus silicone implants. She is doing well and has no complications.