Any Hope for Correcting Recurrent Symmastia?

I had BA in 2007, originally had 36A chest. The surgeon in MA placed saline round smooth implants. After surgery I noticed something wasn't right. I spoke to the doc on many times who wouldn't admit anything was wrong. I have symmastia and asked what I can do but he kept saying that my breasts were ok.

Recently I went to FL and had them replaced with a lift. The doc noticed how bad the symmastia was. My breast are now different sizes and still, I have symmastia.

Can I fix this or is it a lost cause? If I get them removed, will I still have symmastia? Will they ever look normal again?

Doctor Answers 8

Any Hope for Correcting Recurrent Symmastia

#Symmastia is a condition which can occur when the implants are too close together. Patients often refer to this as a “uniboob.” Occasionally, the space or pocket for the breast implant is created towards the center, or the tissue stretches, forcing  the implants to fall too much towards the center of the breasts.  
Correction of this problem may involve using different implants such as textured, a smaller size, or a smaller base and placing the implants in a new pocket. Sometimes, this may require surgery in more than one stage to allow the tissues to heal and then place the implants. If the implants have been placed above the muscle, converting them under the muscle frequently will help and, again, the use of a dermal substitute may be required for additional support if the tissues are thin. The techniques of #capsulorrhaphy and #neopectoral pockets may apply here as well. 

It is difficult to determine and make recommendations to you without photos. Nevertheless, it's best to contact your plastic surgeon to explain your concern in better detail. She or he can then provide you with suggestions based on your surgery experience and individual needs.

Orange County Plastic Surgeon
4.9 out of 5 stars 110 reviews

Symmastia surgery

Symmastia (medial malposition breast implants) can be corrected with high likelihood of success using medial breasts implant pocket sutures  (medial capsulorrhaphy), lateral capsulotomy (if necessary), and/or the use of allograft. I do not believe that a staged procedure, involving removal of implants for period of time, is necessary.
There is a learning curve with this operation and I recommend that you seek consultation with a board-certified plastic surgeon with significant experience treating this problem. You may find the link attached below helpful.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,499 reviews


Without photos, it is hard to say what the exact problem is.  That is if it is a true symmastia.  These can be very difficult to fix.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Synmastia repair

Certainly this can be corrected, but it requires a detailed plan, alot of surgical work, and a very strict post-op recovery period.  There are many different ways to address this issue, but it does not require that you remove the implants and leave them out for a length of time.  However, even with the best repairs, it can recur.  That is why you want to go to someone who does a fair amount of breast revision surgery  This is a difficult issue with a complex solution, and should only be done with every resource available.

Christopher V. Pelletiere, MD
Barrington Plastic Surgeon
4.8 out of 5 stars 75 reviews

Correcting recurrent symmastia

Symmastia takes place when either the surgeon or the breast implants (which frequently are too large) form a partial or complete opening between the two breast pockets allowing the breast implants to touch. The street name for this is "Uni Boob".

It is important to know if you started with submuscular implants or not and which repairs were attempted the second time around as this would definitely suggest the next repair effort.

The repair would depend on putting in smaller implants and re-recreating the flatness and an intervening wall between the breast pockets. This latter is done by stitching the scar tissue wall along the inner wall to the chest and may require placement of an Alloderm or Strattice baffle as well. Unfortunately, repair of symmastia is not easy and even if successful, recurrence of the deformity is sometimes seen.

Good Luck.

Peter A. Aldea, MD
Memphis Plastic Surgeon
4.9 out of 5 stars 109 reviews

Recurrent synmastia

This is a complex problem and needs more detailed information. However, if you are looking for a definitive solution, the best answer would be to take the implants out, suture repair the muscle and/or obliterate the tunnel and leave them out. If you deisire augmentation. I would wait a period of two years after that.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 82 reviews

Correction of synmastia is challenging

You have left out several details in your story that would help like whether your implants are below the muscle or not and whether they were exchanged above or below the muscle at your second surgery and if an attempt was made to repair the problem.

One thing you might need to consider is having them out for 4-6 months. Then have new ones placed in a different pocket using smaller, not larger!, textured implants.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 67 reviews

Synmastia is sometimes tough to correct but it can be

Synmastia occurs most often when implants are placed partially under the muscle and the dissection may be a little too aggressive close to the breast bone (sternum). You didn't mention if the second surgeon tried to repair it. Bottom line is that there is usually something that can be done but you would need to be seen and evaluated. If your implants are under the muscle there is a technique called neosubpectoral pocket popularized by Dr. Maxwell that has been used successfully. I would search out a plastic surgeon close by you unless you want to travel who can examine you and determine if they can repair it. Acellular Dermal Matrix (fancy description of using someone elses dermis) has also been helpful at supporting the repair. I hope this helps.

Dr Edwards

Michael C. Edwards, MD, FACS
Las Vegas Plastic Surgeon
5.0 out of 5 stars 35 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.