Silicone or Saline breast implants are performed for cosmetic reasons by plastic surgeons. In some cases, an old saline or silicone breast implant may have to be repaired or revised because of capsular contracture, uneven breast shape, breast thickening, breast asymmetry, or hardening of the breast. Dr. Karamanoukian is a board certified plastic surgeon who performs cosmetic surgery including liposuction, tummy tucks, laser liposuction, breast augmentation, breast lifts, and breast reduction. He is known for his expertise in the correction of breast asymmetry, breast implant rupture, capsular contracture, and breast rippling, and breast scars.
Synmastia is one of the rare complications that can occur with breast augmentation (breast implants). In breast synmastia, the space between the two implants along the midline chest wall is narrowed and may even be connected. In some cases, the two breast implants may communicate via a small subpectoral or subcutaneous connection.
Correction of synmastia begins with a careful examination of the breasts to identify visual evidence of synmastia at rest and simulated synmastia resulting from medial retraction of the breast implants. Synmastia can also be a unilateral problems characterized by a breast implant that crosses the midline sternum.
Implant malposition is usually to blame for synmastia. The implant pocket usually extends beyond the area of the breast parenchyma and crosses the midline border of the breast. Unlike normal cleavage, synmastia causes a noticeable deformity that destroys normal breast contour and shape. The cause of synmastia is well described in two separate papers written by Spear, Bogue, and Thomassen; and M. Jewell. In these two well written descriptions of breast synmastia, the specific causes for the deformity include 1) medial overdissection of the breast pocket, 2) excessively large breast implants, 3) improper breast implant diameter vs. chest diameter. In my experience, I have also found that breast synmastia also occurs from postoperative retraction and attenuation of the medial pectoralis breast fibers (insertion of the pectoralis major along the sterna head).
Breast synmastia can be corrected using definitive strategies to reestablish periosteal-dermal stability along the midline sternum. I have performed this procedure in varying degrees in patients who present with frank synmastia and in patients who have marked medial breast implant asymmetry in the absence of synmastia.
If you believe you have synmastia, there are options to surgically correct the condition but this demands a comprehensive surgical strategy that incorporates several important principles of cosmetic and reconstructive plastic surgery. Please call our office to schedule a consultation at (310) 998-5534.