Do I Have 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. 

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. 

Looks like symmastia.  Breast augmentation will make it more pronounced.  Your breast are beautiful and symmetrical with good size.  If the symmastia is a great concern, the i would not have breast augmentation.

From your pictures, it does look like you have synmastia.  I agree that your best and easiest first-line option would be judicious liposuction in the area of your cleavage followed by prolonged compression to get the area to scar down nicely and create space between the breasts over your sternum.  After that, if you want a breast augmentation, you can probably safely attempt it, knowing that that area must not be disturbed during augmentation surgery.  If it is disturbed you could recreate the synmastia.

Good luck,

Dr. Shah

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.

1.  Breast Implants:  without examining you it is impossible to be 100% sure; but a higher profile breast implant placed under the muscle can give you nice results.  Your doctor has to make sure the middle part of the muscles are all kept intact.  I do not recoment you go too big.

2. Liposuction:  This is important to accentuate the cleavage.  Most probably the fullness in the middle is only fat (Not breast tissue) and liposuction can reduce that and enhance the cleavage and breast contours. 

3. Garments: There are several garment manufactures that make good compression straps for the sternum  [Veronique: 455VN Sternum Compression V Panel is one of them]

I agree that breast augmentation alone will likely worsen this problem and you do have congenital symmastia. Your best option is liposuction on top of the breast bone with compression to the area afterward. It will be very difficult to get that compression in that area given the natural surface contours of the torso and breast. You may need a custom made garment to get that compression and the most out of the liposuction procedure. Be careful where your liposuction access sites are made as incisions in the midline between the breasts are at greater risk for forming bad scars. You could then do the breast augmentation at a later date.

I hope you realize that this format of posting questions and receiving answers lacks the face to face direct communication required for you to make an informed decision regarding your surgery.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

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.

Hello,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

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.