Do I have signs of symmastia?

Question

I am 11 weeks po with 450cc mod+ submuscular. I have been getting this achy rigging feeling on my breastbone all along. My implanta seem to be moving closer and closer together. I also have significant rippling in the middle, right side. If I do have symastia, how soon can I have reconstruction? I am quite upset with my results so far.

Jed H. Horowitz, MD, FACS · Answer

#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. You show signs that may be symmastia. However, it is best to consult with your Plastic Surgeon to better determine with an in-person exam.

Miguel Delgado, MD · Answer

I do see this as a problem but it is not symmastia yet.  If the implants are truly under the muscle this would not occur unless the muscle was cut medial.  This is something which is not commonly done.   Revision surgery may be required. Good luck

Curtis Wong, MD · Answer

and your skin is thin for you to have rippling as you describe.  Discuss options with your surgeon and you can have implants repositioned or implants changed to improve your appearances.

Benjamin Chu, MD, FACS · Answer

Symmastia is caused by using implant sizes that are at the limit of your maximum breast width and then wearing bras that push up and in.  Almost all Victoria Secret bras push the breasts in.  Victoria secret bras are for women who wish they have bigger breasts.  If you have big breasts already you don't need to push them in more.  If you look at your photo in a bra your two breasts are push in so much compared with when you don't have a bra on.  This leads to gradual thinning of the tissue in the medial part of the breast.  If you don't have much tissue to begin with and you start thinning the tissue medially that's when you will see rippling and develop a symmastia problem.  The solution now is not to wear these push up bras.  If you have to wear a bra make sure its measured to the right size and the bra does not displace your implants medially.  I would recommend you wearing a breast separator bra.  Veronique and Thong bras both have symmastia prevention bras.  Remember it took almost three months to push your implants in and it will take three months or longer of wearing the symmastia prevention bras to correct this.

Tom J. Pousti, MD · Answer

I am sorry to hear about your concerns after breast augmentation surgery. I understand your concerns; your breast implants appear to be very close to one another in the midline area.  However, they do not cross the midline and therefore you do not have "true" symmastia.  Revisionary breast surgery (capsulorrhaphy) may be necessary to improve your breast implant position. You may find this attached link (demonstrating similar cases) helpful as you learn more. Best Wishes.

Frederic H. Corbin, MD (license restricted) · Answer

Thank you for the photos and the question and your right implant unfortunately  does appear to be crossing the midline but this would require a full examination to be certain.  So go back and see your surgeon and express your concerns.

Do I have signs of symmastia?

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