Am I Developing Symmastia 5 Years Post Breast Augmentation?

I had a breast augmentation about 5 years ago, and never had much breast tissue to begin with pre-op as I am very thin. 5 years down the road, I feel my breasts are beginning to become very close together (pls see pic taken recently). Do I have symmastia? Please help, thanks!

Doctor Answers 6

No, not symmastia

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I do not think you are deveoping Symmasta. It appears to me that your implant pockets have closed down laterally forcing your implants toward each other in the middle. The nipples should be centered on the breast mound. If you undergo pocket revision, this can be corrected. I agree you should seek advice from your surgeon or another Board Certified Plastic Surgeon in your area.


Breast Augmentation & symmastia

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Thin patients with large breast implants are more prone to develope symmastia, especially if generous dissections are pereformed medially & breasts are constantly pushed medially. Thanks for posting your photos , your left breast appears to be o.k. , however your right one is displaced medially & you are at risk of having symmastia. Try to put some spacer (padding) on the inner side of your right breast and reduce using your chest musles for heavy work whenever you can. 

Breast implant revision

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Your photo shows implant malposition.  Although the implants are too close together, you do not have actual symmastia which is a condition when the implants cross the midline to create a single pocket across the chest resulting in a "uniboob" appearance.  You should seek out the advice of a board certified plastic surgeon in your area to undergo corrective surgery.

Andrew P. Giacobbe, MD
Buffalo Plastic Surgeon

Breast augmentation revision

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Your posted photo shows a number of issues some of which may be related to your presurgery state. The right nipple is further from the midline than the left, the left implant and crease under that breast is lower than that on the right, the edges of the implants are highly visible, the implants are not centered under the nipples (they are both shifted toward the midline giving you the symmastia appearance).

You probably had some asymmetries before breast augmenation that were not corrected for at surgery. It appears that you would need smaller base diameter implants, capsulectomies, left capsullorhaphy to correct the left breast fold and possible skin procedures to adjust nipple position,

The best thing you could do is get copies of the medical records from your first breast surgery. That will allow your next prospective surgeon to know what he/she is getting into (your presurgery condition and what was done at surgery) and plan for 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.

Aaron Stone, MD
Los Angeles Plastic Surgeon

You do not have symmastia

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Your pictures show malposition of the implants. The left implant is bottoming out and the right implant is too medial and nipple is move too lateral. If you are not happy with the results, you can have pocket revision without changing the implant size.

Symmastia or just implant mal-position?

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Symmastia - commonly referred to as bread-loafing or uni-boob, occurs when two implants touch one another in the center of the chest. If the horizontal muscle that is connected to the sternum and goes across the implant is cut during surgery, then the implant can move toward the middle of the chest and the 2 implants will communicate.  True Symmastia is rare, but more frequent is "implant mal-position". I think this is what you have. Implant mal-position is when the implant moves medially (to the midline), laterally (out toward the armpits) or downwards and a good sign is when you see the nipple/areola complex position change and appear off center.  Implant mal-position can be improved with the internal suture technique (capsulorrhaphy).  You should do your research to choose a board certified plastic surgeon who has experience with this specific procedure.  Please be aware that although the implant malposition may be corrected, the "tenting" that may occur from the raised skin may not be amendable to surgical correction.

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.