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Synmastia or Just Really Close Cleavage? (photo)

asked 5 months ago by courtney2411
Latest answer by Jeffrey M. Darrow, MD
Question viewed 594 times
Tags: cleavage, revision, symmastia

I'm 6 weeks post op today.I went to my cosmetic surgeon (yes consmetic:( wish I had used a board certified PS now) yesterday because I was afraid that I may have symmastia.He says he doesnt think so then tells me hes never seen it in person only in books & internet.He then told me they are to close & I would need a revision surgery.I'm not sure he knows....Does this look like symmastia??I'm not sure if it is or if its just really close cleavage.I have a consult in person with a PS not CS on 15th

22 answers to Synmastia or Just Really Close Cleavage? (photo)

Symmastia

Hi. From the photos, it does not appear to be true symmastia at this time, as the skin still appears correctly attached to the pre-sternal area. Hopefully, it will stay attached! Large implants, requesting tight cleavage, and pectus excavatum make this problem more likely - but it can usually be repaired surgically. Get a consult from a local PS, as assessment from photos can be somewhat limited.

Thomas Fiala, MD
Altamonte Springs Plastic Surgeon

www.plasticsurgeryinflorida.com

Synmastia?

Your photos suggest that your implants are very close together but not true synmastia. The implants appear to be to large as well. Seeing a board certified plastic surgeon to discuss your options at this point is a good decision.

Todd C. Case, MD
Tucson Plastic Surgeon

Concerns about symmastia

Confused by all the answers? Your situation which is an incredibly common one should be a lesson to all those reading the answers provided by plastic surgeon experts. Though there is never any guarantee, when looking for a doctor to perform your cosmetic surgery (most), it would be very wise for your search to consider only plastic surgeons. Otherwise, it is buyer beware... You don't have true symmastia yet but your implants are abnormally close and too large. You may very well... more

Steven Turkeltaub, MD
Scottsdale Plastic Surgeon

www.turkeltaub.com

Symmastia vs. close cleavage

Thank you for your question and photographs. There is a very fine line between actual symmastia and just close cleavage. As you are just 6 weeks post-op, you may not have the final answer yet. It does look like your implants are positioned too close together and it may well be that you are on the verge of developing symmastia. You are doing the right thing by seeing a board certified plastic surgeon for an evaluation. You may benefit from having the outer portions of your pockets opened up... more

James McMahan, MD
Columbus Plastic Surgeon

Breast augmentation -getting it right the first time

I would consider your posted photos symmastia and am very sorry you had to go through this. The implants are way too large for your body frame. In the bending over photo the right implant is so large it goes out past the edge of your body. The saddest thing is that you will have to remove the implants and start all over. You will be paying twice for something that should have been done once. The most important thing for you to do is pick an appropriate surgeon on the next round, make... more

Aaron Stone, MD
Los Angeles Plastic Surgeon

Yes, you have really close cleavage (which could be early symmastia).

Your implants are not centered beneath your nipples; they are medially displaced and would appear more natural if they were both slightly smaller, and more laterally positioned. When you push your breasts together, if the skin above your breastbone pushes aways from the bony attachments, then this is symmastia. If the cleavage stays deep and attached, this is just "close" cleavage but could eventually develop into symmastia, particularly when you wear a bra that will naturally... more

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon

Do I have symmastia?

You don't have symmastia in my opinion, and do not "need" a revision. The shape of your ribs influences final implant position, and you may have a forme fruste of pectus excavatum based on one photo. It is difficult to tell without exam. Even with revision by implant replacement, capsulorrhaphy, and other maneuvers, the result you desire may be difficult or impossible to achieve. Look at the positive: You're a thin woman who has true... more

Steve Laverson, MD
San Diego Plastic Surgeon

Narrow cleavage is different from symmastia.

Pre-operative assessment with photos and a current examination is needed to give you advice. Your breast implants are very close together, your tissue is thin and your implants are too large for your chest. Even if there is still some tissue separating your breast contours (therefore not symmastia), you are very likely to develop problems as your tissues stretches and thins further. Getting another opinion by a Plastic Surgeon is your best place to sort out your current... more

Mathew C. Mosher, MD
Vancouver Plastic Surgeon

www.drmosher.com

Synmastia after Breast Augmentation

From the photos that you show us, we can see that your frame is fairly petite, and that the implants are probably too large and medially (towards the middle of the body) displaced. It may not be actual synmastia, as the skin overlying the sternum appears to by adherent to that bone, and not lifted off of it. Talk to your surgeon, and see if he/she has any suggestions. You may need to replace the implants with smaller ones, or perhaps adjust the pockets or the placement of the implants. The... more

Daniel Kaufman, MD
New York Plastic Surgeon

Symmastia

First, it is always helpful to see preop photos because some women with large natural breasts sometimes have this. But with implants, and jsut based on the photos, it looks like you have symmastia.

Steven Wallach, MD
Manhattan Plastic Surgeon

Cleavage versus synmastia

Yes, your implants are very close together. These implants seem large and wide in proportion to your small frame. You may develop a synmastia in the future but do not have one right now. One logical solution is to have them changed out for smaller implants that are narrower. This will let them be slightly farther apart. It depends on how much it bothers you. But for right now, no, this is not synmastia in the usuall discription of synmasia.

J. Jason Wendel, MD
Nashville Plastic Surgeon

www.mc.vanderbilt.edu

Cleavage or symmastia

Your breast does run together into the middle, and the skin is lifted off the sternum. The implants are round and projecting, even when you are on your back. The question will be how much the appearance bothers you as the fix may not be easy. Best of luck, peterejohnsonmd.com

Peter E. Johnson, MD
Chicago Plastic Surgeon

www.peterejohnsonmd.com

Synmastia or Very Close Cleavage

It appears from your photograph that your implants are very close and there should naturally be a space between your breasts. The diagnosis of this would be made if you push your implants toward the center and they "lift" the skin off the chest bone and even approach the other side (it appears that your left breast is across the midline already). If this is the case then you need to have revisionary surgery where the internal "capsule" is tightened with sutures or even... more

Vincent P. Marin, MD
San Diego Plastic Surgeon

www.marinaesthetics.com

Symmastia?

It appears that your impants are too large and the pockets too medial. You should be very careful when you massage your breasts not to move them medially ( toward the middle of the chest). The plastic surgeon you will be seeing can guide you on how to care for your breasts, and I am glad you are seeing him/her.

William H. Gorman, MD
Austin Plastic Surgeon

Very large breasts and symmastia or synmastia

While you don't appear to have synmastia (symmastia), you do have very large implants which are placed relatively centrally relative to the nipples. We term this medial malposition. If they were placed under the muscle, this will almost certainly be associated with widespread removal of the muscle tissue from the sternum, causing the chest muscle to move weirdly. If they were placed above the muscle, the circulation from the chest muscle to the breast itself is now divided,... more

Brent Moelleken, MD
Beverly Hills Plastic Surgeon

Synmastia

I agree with the comments of the other surgeons who have responded. Your implants are fairly large for your small ribcage and they are very close together. Correction is possible, but can be expensive with new implants and possibly the use of dermal matrix material. I would pose a question to you before considering revision. How much does it bother you now? If it does not bother you a great deal, I would recommend waiting. It can be fixed at any time later... more

Donald Griffin, MD
Nashville Plastic Surgeon

Symmastia after Breast Augmentation

Your breast do appear to be very close together. You may indeed have symmastia, which can worsen over time. If your breast implants were placed above the muscle, you may want to consider having your implants being placed under the muscle to correct this deformity. If they are under the muscle, either a new pocket under the muscle has be created (neo-subpectoral approach) or you may need a internal graft to support the implant pocket to prevent the deformity from recurring. You should consult... more

Ankit Desai, MD
Jacksonville Plastic Surgeon

Are the implants too close together?

Thank you for the pictures. Indeed the implants are very close together. A true synmastia will eventually show a tenting of the skin between the breasts. I do not see that as yet. The implants may relax and move outwards over time if they are under the muscle and the insertion of the pectoral muscle is intact. At six weeks you are still early in your result. Sometimes a chest wall assymetry or depression (pectus excavatum) can cause the implants to lean toward... more

Adam Tattelbaum, MD
Washington DC Plastic Surgeon

Symmastia ("Uniboob")

Your cosmetic surgeon put in a pair of implants which were too large for your chest. To keep them from falling to the sides, he lifted the breast tissue off the chest wall along the breast bone (sternum) allowing a very narrow bridge of skin to be the only thing which separates the two implants. Your implants ARE close, VERY close to the point they could hold a pencil between them. While it is not a symmastia YET, it is clearly impending symmastia. Furthermore, if such a... more

Peter A. Aldea, MD
Memphis Plastic Surgeon

Symmastia?

Thank you for the question and pictures. There is no doubt that your breast implants are medially mal-positioned. This appears to be more so on your left side than on the right. Whether or not you have “symmastia” is a matter of semantics. You may find the following paragraphs informative..... Medial displacement of breast implants is known as symmastia. This is commonly referred to as "breadloafing" or "uni-boob". This results... more

Tom J. Pousti, MD
San Diego Plastic Surgeon

www.poustiplasticsurgery.com

Your very close cleavage may lead to synmastia.

You do not have true synmastia yet. Your implants were placed very close together but there is no tenting of the skin between them so (although photos limit the evaluation) your skin is still attached to your sternum. This may not be true in the future. Your decision to see a board certified plastic surgeon is a sound one and this person should be able to guide you.

Jeffrey M. Darrow, MD
Boston Plastic Surgeon

Synmastia or Just Really Close Cleavage? (photo)

The majority of the expert response agree with your diagnosis. The lesson learned is obtain a few consults and include at least 3 from boarded PSs in your area.