srsmiami.com

The thong brassiere after synmastia surgery

Had an MTF patient who had saline implants and a urethral spongiosum rest from surgery done elsewhere who requested an exchange from saline to silicone cohesive gel.  Prior to  revision of breast augmentation done by an accomplished plastic surgeon, synmastia (often spelled symmastia) or in layman’s talk (uniboob) was noted.  The medial borders of the implants seemed to touch each other at the upper sternum and lifted the skin upwards more than expected.  This is the inherent danger when one releases pectoralis muscle attachment to the sternum above the 7th rib.   Most synmastias occur with subpectoral implants.  Women normally do not have cleavage unless they wear a bra which pulls their breast together.   Doctors who try to comply and get too close may over-dissect the tissues.

The implants were dealt with first.  “Always do the most sterile part of the case initially.”   Some adhesions in the capsule were opened which allowed the new implants to move more laterally and downwards.  This caused the nipple areolar complex which was unusually lateral in this patient to assume a more central position.   A male nipple areolar complex tends to more lateral, so thought must be given to avoid pushing it even more laterally with too medial a placement of the implant.

To prevent reentry of the implant into the sternal area, a thong bra is being used for 8 post-operative weeks.  The central strap has a soft wedge underneath which compresses the midline skin and keeps the implants somewhat laterally.

Today she was quite excited about their appearance and feel.  That’s her job; had my chance.  Did look really nice though.

Perhaps a photo soon.

Harold M. Reed, M.D.