Do I have Symmastia? (Photo)

I'm about 10 months post op Just had a classic breast augmentation with 520cc silicone implants under the muscle. Was 10A now 10E. I'm concerned that they are too close together. I do have cleavage when I push them together but the skin across my sternum is raised about half a cm

Doctor Answers 4

After breast implant surgery: You do not have symmastia

It does not appear that you have symmastia. It s not common and is usually caused by the surgeon trying to create more cleavage by raising skin and muscles over the breastbone, an appearance which some refer to as a uniboob or bread-loafing. Hope this is reassuring. For more information on this and similar topics, I recommend a plastic surgery Q&A book like "The Scoop On Breasts: A Plastic Surgeon Busts the Myths."

Philadelphia Plastic Surgeon
5.0 out of 5 stars 78 reviews

Breast augmentation

Your implants are close together but this is not symmastia from what I can see from the photos that you have posted

Gary L. Ross, MBChB, FRCS
Manchester Plastic Surgeon
5.0 out of 5 stars 165 reviews

Do I have Symmastia?

No, I don't think you have symmastia.  

I think you have "tenting" which a phenomenon which can occur simply due to large implants.  A 520 cc implant will most likely have a base width that when added the base width of the other implant, will take up most of the width of your chest.  This means that there will be minimal space between your breasts, giving you a deep cleavage but also possibly stretching the skin between the implants.

I think you have a nice result and you need not worry about symmastia.  The photos suggest that you have a well defined area of attachment of the soft tissues to the sternum and it is unlikely that symmastia will develop with time.

If you have ongoing concerns I suggest you consult your PS for reassurance.

Kind regards,


Dean Trotter, MBBS, FRACS
Melbourne Plastic Surgeon
5.0 out of 5 stars 39 reviews

Do I have 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. Additional surgery (capsulorraphy) will be necessary increase the space between the breast implants.

In my practice, having used a variety of “techniques” for correction of symmastia, I find that the most reliable technique involves a 2 layer capsulorrhaphy (internal suture repair of the breast implant pockets along the cleavage area). Often, the use of acellular dermal matrix is helpful also. I have also been pleased with the (at least partial) correction of skin tenting that can be achieved with the use of the acellular dermal matrix.
Often, it is necessary to “open” (reverse capsulotomy) the breast implant pocket laterally (outer breast fold) to allow for positioning of the implant centrally behind the breast mound. This maneuver may also decrease the amount of implant pressure against the medial suture line.
I also find that careful attention to postoperative activity restrictions is key to success with this type of surgery and other types of implant malposition revisionary breast surgery.
Again, your plastic surgeon will be your best resource when it comes to more specifics. You may find attached link helpful to you when it comes to more general symmastia corrective surgery concerns.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,488 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.