7 months post op - could I be experiencing symmastia? (photos)

Question

I had my surgery about 7 months ago now and have been concerned with the absence of a gap between my breasts when they are pushed together and when I bend over. I have raised issues with my surgeon but he does not seem to want to recognise the issue and I am seeking other opinions on the matter

Semih Yildiz, MD, FEPOBRAS · Answer

I reviewed the two photos. Your breasts do come very close together centrally, especially when they are pushed together, but photos alone cannot confirm true symmastia because the key finding is whether the skin and soft tissue over the breastbone are being lifted off the sternum and whether the implant pockets cross the midline.

True symmastia is more than having close cleavage. It usually involves loss of the normal medial breast fold, tenting of the central skin, or implants that move toward each other in a way that does not feel supported by the sternum. This is best checked in person with your arms relaxed, with pectoral muscle contraction if the implants are under the muscle, and while leaning forward, because photos in a bra or with the breasts pushed together can exaggerate the appearance.

At 7 months, the result is mostly settled, so getting a second opinion from a board-certified plastic surgeon who does a lot of breast revision is reasonable. Until you are examined, avoid aggressive massage or tight push-up bras that force the implants inward. If symmastia is confirmed and it bothers you enough to revise, treatment may involve internal pocket repair/capsulorrhaphy, reinforcement with mesh or acellular dermal matrix in selected cases, pocket conversion, and sometimes smaller or narrower implants. The exact plan depends on implant size, pocket position, tissue strength, and whether the implant has actually crossed the midline.

Daniel Barrett, MD · Answer

Dear Cami.g,
based on your photos, it doesn't look like you have symmastia. I understand your concern. However, without a proper assessment, it would be difficult to determine what is wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Connie Hiers, MD, FACS · Answer

Your photos are limited and do not provide a full view of your breasts. with what I see, I doubt you have symmastia, but your implants are probably too large and wide for your frame. Please submit better photos with you standing nude and arms at your sides.

Camille Cash, MD · Answer

It's difficult to tell from the provided photos if symmastia is present.  If it is, it is a mild case.  When you visit other surgeons for their opinion you should be able to have a more definitive answer.

Elaina Chen, MD · Answer

It's hard to tell with photographs in a bra that push your breasts together, and without a preop photograph to compare. Are your implants submuscular, subfascial, or subglandular? Some patients naturally have symmastia that is made more noticeable with breast augmentation. Without these additional pieces of information, it's difficult to give you any recommendations.

7 months post op - could I be experiencing symmastia? (photos)

Answers (5)

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