Do I Have Congenital Symmastia?

My breasts are naturally really close together and they feel webbed toward the bottom. I have NO cleavage! Do I have congenital symmastia? Is there a way to create more space between my breasts and is breast augmentation still possible?

Doctor Answers 24

Congenital Symmastia (Joined Breasts, "Uni Boob")

You do have symmastia. I would recommend against worsening it with a Breast Augmentation. Your options are either to leave it alone or to perform liposuction of the area with long term compression (thong bra etc) to get more definition over the sternum (chest bone)

Memphis Plastic Surgeon
4.9 out of 5 stars 109 reviews

Congenital symmastia

Your breasts are symmetric, and beautiful. Difficult to determine by photo alone if this is true symmastia (is there breast tissue behind your midline confluence, or just skin and fat?). In any case, breast augmentation, in my opinion, by enlarging the beast mounds, will likely render your midline tissue less prominent and relatively less visible. Would proceed very carefully and with circumspection before midline liposuction. By deflating midline subcutaneous fat, skin may sag, and the midline crease may become more prominent.

Steve Laverson, MD
San Diego Plastic Surgeon
4.9 out of 5 stars 47 reviews

Treatment of Congenital Symmastia

When breast creases on two sides connect with each other they cause a webbing accross center of chest.  Connection on two sides can be disrrupted by doing tissue rearrangements in the area of webbing.  However often this causes bad scars and is not worth doing.

It is possible to get breast augmentation in your situation.  However the symmastia would persist unless webbing is disrrupted.  

Vasdev Rai, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 23 reviews

Congenital Symmastia Repair


Thank you for the question and the photo.  There is a good solution for congenital symmastia. I use a small incision in the breast fold to repair and separate the breasts to provide a normal amount of cleavage. Other plastic surgeons advocate implants and /or liposuction but I have found that suturing the tissue works the best in my hands. Recovery and results are usually excellent.  The link below shows before and after photos of a patient that underwent congenital symmastia repair by this method.

All the best,

Dr. Remus Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 166 reviews

Not really a "uniboob"

Symmastia is when the two breast are basically "fused" together and form one breast, a "uniboob".  So, you really don't have symmastia, but your breasts are very close together and there is very little "gap" between your breasts.  Cleavage is really medial (inside) breast tissue that shows in clothing.  You can create cleavage with push up bras, bathing suits, breast implants, or in your case, you actually have wonderful natural cleavage.  Most women would die to have your shape and size, I would anticipate you are wearing a "C" cup bra.  You can't really uncreate this, and if you have breast implants placed you would have a larger version of your current shape, if you are unhappy with your current shape, I would NOT have implants placed.

David Finkle, MD
Omaha Plastic Surgeon
4.9 out of 5 stars 75 reviews

Yes, maybe, and i wouldn't recommend it.

yes you have synmastia.  your beast soft tissue is meeting in the middle and there is no portion of the bony sternum that is not covered by breast soft tissue.  

Although there is no good solution to this,  you could attempt liposuction of the midline area followed by prolonged (6-8 weeks) of external compression to get the skin to adhere. Breast augmentation with implants would likely accentuate the synmastia, so I would tend to avoid making the synmastia worse.  Breast Augmentation with Fat may be more able to void the midline by virtue of the "preferential fill" afforded by fat transplantation.


Best regards,


Dr Del Vecchio




Daniel Del Vecchio, MD
Boston Plastic Surgeon
4.5 out of 5 stars 180 reviews

Congenital Symmastia

Your pictures demonstrate the presence of a mild congenital symmastia. This condition occurs when the breast tissue merges across the midline. In some cases, this may give the appearance of a large single breast.

Cases of mild congenital symmastia don't usually require surgical treatment. This condition is well tolerated and is almost considered a variant of normal.

If you're concerned about this problem, it's reasonable to consult a board certified plastic surgeon. This surgeon should be able to discuss this condition and the available options for treatment. In some cases, breast augmentation or liposuction may have a role. In your particular case, it's probably reasonable to do nothing and accept what most people would consider to be a relatively attractive breast. 

Richard J. Bruneteau, MD
Omaha Plastic Surgeon
4.9 out of 5 stars 194 reviews

Congenital symmastia

It appears that you do have symmastia, however it can be possibly corrected. This should be done before having breast augmentation.

I would have to say, though, that your breasts appear to have a nice shape regardless and you may find that the risks of breast surgery may not outweigh the benefits.

Ronald Levine, MD
Toronto Plastic Surgeon
4.6 out of 5 stars 24 reviews

Congenital Symmastia

Thank you for the question. 
Unfortunately, without direct examination it is difficult to give you precise advice but it looks like you may have congenital symmastia.  I have found that treatment of congenital symmastia can be challenging. Sometimes patients with “congenital” symmastia  benefit from liposuction surgery of the area between the breasts ( over the sternum);  whether or not you are a candidate for this procedure will depend on your physical examination.
You may find in person consultation with well experienced board-certified plastic surgeons to be helpful to you.
Best wishes.

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

Do I have a congenital symmastia?

It appears you do have a symmastia. I agree with some of the other surgeons that implants may make this worse. I also agree that you have a very nice shape and size to your breasts and would likely not recommend you alter them in any way. 

Christian A. Prada, MD, FACS
Saint Louis Plastic Surgeon
5.0 out of 5 stars 260 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.