Are my implants too close? Am I at risk of symmastia? (photos)

I am about 4.5 months post op. Ive been concerned that my implants were too close and i think i have slight tenting - worried about symmastia. My surgeon at first told me yes I do have symmastia, then said about 2 weeks later that i dont. Its difficult to get a straight answer as i got surgery out of state, so he is going by photos. Will the tenting get worst or does it look normal? Do you think i need revision?

Doctor Answers 6

Are my implants too close? Am I at risk of symmastia?

Your breasts may be close without having symmastia. If the implant pockets are truly communicating or you have significant “tenting” between the breasts, another procedure to correct the issue may be necessary. It is reasonable that you return to your operating surgeon for him/her to evaluate your physical condition and make appropriate recommendations. Should you still have questions or concerns, you should seek a second opinion through a consultations with an ABPS certified plastic surgeon.

Houston Plastic Surgeon
3.9 out of 5 stars 7 reviews


This is not synmastia but your implants are relatively centrally positioned. Over time it is common for implants to stretch out the skin laterally and slowly "sag" in that direction which may steadily improve the position of your implants relative to the nipple. If not, improvement might be possible by expanding your pockets laterally so the implants can "roll away" from the middle, with or without suturing or cautery contracting the capsules centrally. It is possible that you might lose some of the sensation to your nipples with lateral pocket expansion so I think it makes sense to wait at least a year to see how this evolves before you consider surgical revision.

Gregory J. Stagnone, MD
Dallas Plastic Surgeon
4.6 out of 5 stars 40 reviews

Are my implants too close? Am I at risk of symmastia?

Based on your photos you do not have symmastia. However your implants are quite close together.  I would wait another 3-4 months because he implants should drop and spread more.  If after a year post surgery you are concerned and unhappy with the closeness a revision can be done.


Thank you for your questions and photographs.  Your photographs do show that your implants are quite close but do not indicate symmastia.  Best to discuss the position of the implants with your surgeon.  Best of luck.

Are my implants too close? Am I at risk of symmastia?

Although your concerns are understandable, your pictures do not demonstrate symmastia. You are correct in that your breast implants are quite close to the mid line and some skin elevation (tenting) may be present. If, in the long term, you remain concerned about the breast implant positioning, additional surgery (capsulorraphy) will be necessary increase the space between the breast implants.  In my practice, I would use a 2 layer suture "repair" of the medial breast fold are plus/minus acellular dermal matrix for additional support as needed.
You may find the attached link, demonstrating cases of symmastia helpful to your peace of mind. Best wishes

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,501 reviews


I don't think you have symmastia, which is when the breasts become one across the midline.  You have a small space, but it is very narrow, and that is probably what you don't like about it.  Hopefully the tenting won't get worse, and maybe taping or putting a spacer in there will help the implants settle more separately.  But if it doesn't improve and it continues to bother you, you would need a revision. Those implants may to be wide for your body.  Also, if a patients chest is concave under the implants, it tends to point them inward.  

Tyler C. Street, MD
Napa Plastic Surgeon
5.0 out of 5 stars 4 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.