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 23

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 100 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 44 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 21 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 153 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 69 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




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
4.7 out of 5 stars 19 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.

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. 

Can Synmastia Exist Prior To Getting Breast Implants?

Are you confused yet?
It's amazing how many different opinions there are on this subject!
Technically, Synmastia is a term that is used to describe the loss of attachments of the skin to the breast bone.   I don't see this in your pictures.  This is usually due to implants being placed on top of the muscle and winding up too close together, often to a point where they can be pushed across the midline of your chest.  I doubt your breasts can be pushed  across the midline. Synmastia is most likely to occur with larger implants on top of the muscle.  Although this can occur when implants are placed under the muscle, it is VERY Rare! 
You have beautiful breasts as they are.  If the lack of space between your breasts bothers you, I do believe that liposusction of this crease can give you more space and I have done this in the past with no visible scaring as I do it through the Belly Button.  I also believe that SubPectoral (Submuscular) implants would likely improve your cleavage as well as the depth of the crease between your breasts. Of course an examination in person is the only way to really know. 
Good Luck
Dr M 

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