Uniboob; is there anything I can do to prevent this?

I'm considering getting implants. I'm around a 32B and would like to be a full D. I am completely terrified of symmastia. Is there anything i can do to prevent this? I have a very small frame, would getting a large implant (350-400cc) have a greater chance of this happening?

Doctor Answers 10

See a Board Certified Surgeon to Decrease Your Chances of Complications

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#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.  

Your procedures should always be performed by a #PlasticSurgeon who is board-certified and has a great deal of experience specializing in cosmetic #surgery. You will then greatly improve your chances of getting the result you desire, and, without the need for a revision surgery. It is suggested that you look at before and after photos of the surgeons actual patients, and read patient reviews. Gathering all of this information will help you make a well-informed decision.

Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

Uniboob or Synmastia

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Thanks for your question.  First of all, synmastia is not a common occurrence.  Secondly, it is important that you not go too big.  If you go beyond the diameter of your breasts extensively, then you have a higher chance of having this happen because basically the surgeon has to open all the tissue planes in order to be able to accommodate the size of the implant.  You can avoid this by having a consultation with a Board Certified Plastic Surgeon who does proper measurements and can recommend an implant size that will safely be able to fit your frame.  I hope this is helpful.  Best of luck!

Hisham Seify, MD, PhD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 19 reviews


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It does not look like symmastia according to your pictures but you should consult with your surgeon to be sure.
Symmastia is a condition which can occur when the implants are too close together. Patients often refer to this as a “uniboob.” This can occur for the same reasons as displacement, but in this case the pocket(s) is/are too far towards the center.
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. On occasion, 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.

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Avoiding symmastia

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takes judgment by your surgeon, choosing smaller sizes, and careful dissection of your pocket.  If you have a frame that can handle the 400 cc dimensions, you should be fine.  If you are very flat, be cautious with the larger sizes as it can sometimes 'tent' the skin upwards if the mounds are too close to each other and result in symmastia still.  And avoid ultrahigh profile implants for sure.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

How to prevent symmastia

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Symmastia is caused by selecting implants that exceeds the widest dimensions your breasts can accommodate.  There is an ideal base width to each breast.  When you select the correct base width of the implant to fit the base width of the breasts you end up with nice cleavage.  The problem then lies with the type of bra that most women use.  The first place women run to after getting their implants is of course Victoria Secret.  They often select a bra that pushes their breasts towards the middle to further enhance the cleavage they have.  Day in and day out the implants are pushed together.  If the cleavage is close the medial part of the breast pocket will stretch and the lateral part of the breast pocket will close due to the external pressures that the implants are subjected to.  This causes the implants to move closer and closer together.  Eventually the small bit of tissue separating the two breasts start to thin and the breasts will end up touching.  If caught early enough breast separator bras such as the Thong Bra can help to reverse some of this damage.  The problem is that the thong bra is ugly and women don't want to wear it.  The best thing to do is to get measured properly for a bra and use a cup size slightly larger to prevent the lateral part of the breast from getting pushed in towards the middle.  Note if you have a bit of capsule formation these push up bras will accentuate the problem even worse.

Benjamin Chu, MD, FACS
Honolulu Plastic Surgeon
4.8 out of 5 stars 106 reviews

Uniboob; is there anything I can do to prevent this?

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Interesting that you have that concern. I have been doing this job for over 30 years and never seen that happen. the only way it could happen would be if the doctor over dissects the implant pocket over the breastbone and there would be no reason for that as long as you are reasonable in the implant sizes you request and he is a technically skilled surgeon. The implant width cannot be any wider than your anatomy allows. 

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 29 reviews

Uniboob; is there anything I can do to prevent this?

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 Thank you for the question. Generally, careful breast implant pocket dissection and careful selection of breast implant size/profile will help minimize chances of breast implant displacement problems such as symmastia ('uniboob").  In other words, the use of a breast implant size too large for a patient's frame can be problematic.

Generally speaking, the best online advice I can give to ladies who are considering breast augmentation surgery ( regarding breast implant size/profile selection) is:
1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. Ask to see lots of examples of his/her work.
2. Again, have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining which operation and/or breast implant size/type/profile will most likely help achieve your goals.
In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or "C or D cup" etc means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup size may also be inaccurate. Therefore, I ask that my patients not base their communication preoperatively OR their satisfaction with the outcome of surgery postoperatively, on achieving a specific cup size. The use of computer imaging may be very helpful during this communication phase.
3. Once you feel you have communicated your goals clearly, allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals. Again, in my practice, this decision is usually made during surgery. The use of temporary intraoperative sizers, viewing the patient's breasts in the upright and supine position, are very helpful during the breast implant selection process.
I hope this, and the attached link (dedicated to breast augmentation surgery concerns), helps. Best wishes.


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Thank you for your question. The best thing you can do is find a board-certified plastic surgeon that you are comfortable with and confident that they will be able to provide you with your desired results. Symmastia most commonly occurs if an implant that is too large for your frame is used and too much dissection is made between the breasts. This is very easy to avoid with the appropriate implant selection and proper surgical technique. Best of luck, Dr. Kludt

Nathan Kludt, MD
Stockton Plastic Surgeon
4.7 out of 5 stars 35 reviews

Uniboob- Symmastia

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Thank you for your question. Yes there is choose an experienced board certified plastic surgeon with great credentials and great reviews. That surgeon should guide you to what is best for you. We can not always get what we want and it sounds like you already know that. Implants that are to wide for your body anatomy can cause uniboob as they need to fit and in order to do so the medial portion of your breast needs to be released. If it released to much the pectoral muscle is detached and you can have your implant actually slide to the other side. With proper measurements of your breast the surgeon can tell you what implants will fit you!
I hope that helps!

Good luck!

Uniboob; is there anything I can do to prevent this?

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Symmastia typically happens when you choose a breast implant size that is wider than the base width of your breast. When the surgeon attempts to make enough room for the too large implant symmastia can occur. Its best to choose an implant the same size or smaller than the width of your breast and be sure to tell the saurgeon your fear.

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.