I Don't Have Symmastia but Still Looks Like Uniboob. Any Method to Restore my Skin Tissue? (photo)

After surgery(June)my doctor said i have symmastia so I wore the thongbra.Now standing upright it’s perfect but if my breasts are getting lift up the skin is too and looks like I have uniboob.However the implants are staying in their place it’s my skin causing the problem.Going submuscular won’t tighten my skin and may still lift up whenever my breasts do.My only choice is to tighten up my skin tissue.But most methoods are firming only the top layers of the skin,not the tissue itself.Any advice?

Doctor Answers 10



You are absolutely right, your breasts look great when you stand upright!  However, they are coming together and lifting the skin off of your sternum when you lean forward.  Unfortunately, this is symmastia and it's correction will require more than a non-surgical technique like skin tightening (BTW, your skin is tight enough there, and couldn't be tighter.)

Regardless of the placement of your implants above or below the muscle, there are a few good options for surgical correction.  Revision breast surgery is complicated and should be performed by very experienced surgeons.  Be sure yours has experience, otherwise do yourself a favor and find someone who does. 

I think you should be able to resolve this issue and have a great result.

Best of luck!

Beverly Hills Plastic Surgeon
4.9 out of 5 stars 89 reviews


Yes it can be fixed.  It will require surgery.  Either "taching sutures" or placing the implants under the muscle is required.  Most plastic surgeons don't see this often as it is an infrequent problem so talk to your surgeon or find someone with lots of breast experience.

Randy Proffitt, MD
Mobile Plastic Surgeon
4.6 out of 5 stars 23 reviews

How best to treat synmastia

It appears by your photos that the best treatment for you would be to change to a sub-muscular augmentation but the pocket overlying the breast bone needs to be repaired or sutured down. You would need to wear your thong bra again while you healed but other than trying to repair the sub-glandular pocket where they are right now. There is no replacement for an in-person physical exam though. I hope this helps.

Dr Edwards

Michael C. Edwards, MD, FACS
Las Vegas Plastic Surgeon
5.0 out of 5 stars 35 reviews

Symmastia correction

It sounds like your implants are on top of your muscle.  That's good news, since putting your implants under the muscle will likely correct the problem.  If surgery is done on the current pocket instead (whether on top or under the muscle), there are more surgical maneuvers that need to be done, and the rate of success a bit lower.  Although I have tried percutaneous technique with some success, I agree with the others that you are looking at having another surgery.  "Tightening" the skin is not what the surgery does, however.

Douglas J. Mackenzie, MD
Santa Barbara Plastic Surgeon
4.8 out of 5 stars 28 reviews


Thanks for the photos. The correct diagnosis is symmastia.  There are no conservative non-surgical methods to correct the problem.  Tighening the skin will not help.  The pocket around the implants are communicating and need to be adjusted (revised)

Todd B. Koch, MD
Buffalo Plastic Surgeon
4.7 out of 5 stars 35 reviews


Judging by your photos, I think your doctor was correct, you do have symastia. The most reliable way to address this problem is to wait until you are completely healed from the first operation and then create a new submuscular pocket just below the original pocket but father from the midline in order to not have the recur. I do not know of any reliable non surgical method of correcting this problem.

Thank you for your question and for the photos, best of luck.

Ralph R. Garramone, MD
Fort Myers Plastic Surgeon
4.8 out of 5 stars 59 reviews

Synmastia correction

Your photos suggest that you do have synmastia. The skin near the inner side of the breasts can be surgically tacted back down to the periosteum (bone covering) of the sternum (bone) from the inside. Placing the implants under the muscle if they are in front will help as well as long as the medial, near the sternum, muscle attatchments are not disrupted. However, you may still need the skin tacted down. In either case, you will like need surgery to correct this.

Todd C. Case, MD
Tucson Plastic Surgeon
4.9 out of 5 stars 55 reviews

Appears as Symmastia when Arms are at Your Side

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. . However, in your case, #symmastia appears possible when both arms are down at your sides. Therefore, it is best to consult with your plastic surgeon to better confirm and determine how it can be addressed if necessary. 

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 109 reviews


It does not look like symmastia according to your pictures but you should consult with your surgeon to be sure.
Symmastia is a condition which can occur when the implants are too close together. Patients often refer to this as a “uniboob.” This can occur for the same reasons as displacement, but in this case the pocket(s) is/are too far towards the center.
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. On occasion, 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.

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 154 reviews

Symmastia Problem

By definition, you do have "breasts together and need to have a separation either by using your own tissue,adding alloderm skin replacement or in addition put implants below the muscle. This must be done by an expert because it tends to reoccur.

C. Andrew Salzberg, MD
Westchester Plastic Surgeon
4.8 out of 5 stars 49 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.