This 21- year old patient from Bonita, California had her previous breast augmentation performed by a plastic surgeon in Tijuana, Mexico almost 2 years ago. This surgeon, who was recommended to her by a friend did not perform standard procedures and placed drains in the patient’s breasts after her procedure. Only after 2 months of her surgery, the patient noticed that she had developed symmastia and was very unhappy with her results and especially the “uniboob” look (the implants were touching down the mid-line).  Notice that the patient no longer has “cleavage”. The patient’s nipple-areola looked displaced to each side. The implants have also “bottomed out”.

The patient was extremely upset about the results and worried about having revisionary surgery to correct her symmastia. She wanted to make sure that this time she went to a board certified Plastic Surgeon who scecialized in symmastia repair and revisionary surgery.

Another friend recommeded Double Board Certified Plastic Surgeon, Dr. Tom Pousti in San Diego, so she met with him for a consultation. She was very impressed by the amount of time that Dr. Pousti spent with her explaining how the revisionary surgery would proceed. Dr. Pousti explained that he uses an “internal suture” technique therefore leaving no additional scars on the outside of the breasts. She was shown pictures of other patients who also had symmastia repair performed by Dr. Pousti.

This patient proceeded with revisionary surgery 2 months after her first consultation with San Diego plastic surgeon, Dr. Tom Pousti. Her surgery took about 2 hours with a lot of time and care taken to make sure that we achieved her goals. After her current implants were removed, Dr. Pousti placed internal sutures to reattach the skin to the chest wall and then placed her new implants under the pectoralis muscle. She has smooth, round, saline filled implants placed under the muscle. She has a 390cc saline implant placed on the right and a 420cc saline implant placed on the left.

During the recovery period, this patient had to wear a special bra called a “thong bra” to help stabilize the area in between the implants where the internal sutures were placed. After taking care to avoid the heavy lifting for the first 4-6 weeks, her recovery proceeded smoothly and she is very happy with her results.

The first week, you will see bruising and swelling due to the work performed creating the “pocket” for the implant. The internal sutures connect the skin to the sternal wall therefore not allowing the implants to “communicate” with each other. Performing the internal suture technique allows the patient to achieve the results with no additional scarring on the outside of the breasts. Notice the development of a cleavage area, correct positioning of the nipple-areola complexes and correction of the “bottoming out” condition.