Is this symmastia? If so, what do you suggest to fix this problem? (Photo)

I've gotten 3 boob jobs from the same Doctor. 1 December 2010 375mod+ sal under 2 August 2011 800 hp sil under 3 January 2012 700 hp sil under With each boob job I haven't had a gap. My implants always touch, the doctor told me after the first change that he messed up by giving my moderate plus profile. The second and third surgery hasn't fixed the gap issue. What are your thoughts on how to fix this? I want normal looking breast. Stats 5'1 100lbs pre op 32a

Doctor Answers 7

Is This Synmastia?

Basically yes you have synmastia, or something very close to it. In some patients they start out with very little or essentially no space between their breasts, but in your case it appears that your implants have completely eliminated whatever space was there originally. This has occurred because your implants are disproportionately far too large for your frame. Your original implants may have been reasonable. Your current implants extend far beyond what would have been the original base width of your breasts.

Fixing this will require a significant downsizing of your implant, suture repair or capsulorraphy of the internal implant pocket and most likely reinforcement of the repair with an ADM material like Strattice or other soft tissue reinforcement such as Seriscaffold. It will be a complex and expensive repair, but there is no easy fix of this problem at this point.

Kirkland Plastic Surgeon
4.8 out of 5 stars 53 reviews

Correction of Symmastia

Hello and thank-you for your question and photo.

I am sorry to hear you are having difficulties.  Symmastia can be challenging problem to correct.   An internal capsulorraphy and re-enforcement with an ADM such as Alloderm, Belloderma or Stratice will be required.  In all likelihood, will need to reduce the size and increase the profile of the implant. I would recommend an in person consultation with a Board-Certified Plastic Surgeon to discuss your options

Thank-you, Andrew Lyos MD, FACS

Andrew T. Lyos, MD, FACS
Houston Plastic Surgeon
4.8 out of 5 stars 59 reviews

Yes you have synmastia

Good morning!
Sorry to hear of your problem but yes you do in fact have synmastia- a close approximation or even communication of the breast implant pockets.  A variety of techniques can be utilized to correct your problem depending upon pocket location and tissue characteristics.  I recommend seeing a board certified plastic surgeon in your area that has experience in revisional cosmetic surgery of the breast.I hope this helps.

Robert Steely, MD, FACS
Houston Plastic Surgeon
4.8 out of 5 stars 56 reviews

Is this symmastia? If so, what do you suggest to fix this problem?

Yes, it is symmastia and occurs because the implants are simply far too big for your chest. You need to go down in size dramatically and have internal capsulorrhaphies and probably the insertion of ADM, if you are going to have a successful repair of this problem. 

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 27 reviews


Yes, you probably do have synmastia. It can be challenging to fix as I am sure you have read elsewhere.  No profile of implant will make a difference, but a smaller implant is something you may need to accept.  Making room in the pocket off to side plus a reinforced repair with ADM like Strattice or Belladerm would also be a part of your repair.  

John LoMonaco, MD, FACS
Houston Plastic Surgeon
5.0 out of 5 stars 271 reviews

Treatment of synmastia

You do appear to have synmastia by the images you have shown. You are a thin woman and almost any profile of implant 700 to 800cc will cause your breasts to touch and thin your tissues. The area in the middle can be repaired to make it appear smoother and I would recommend use of Strattice ADM to provide support of the repair. I recommend you schedule a consultation with a board-certified plastic surgeon with experience in breast revision.I wish you well.Dr. Edwards

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


Hi thanks for your question. Symmastia is typically a description used when the breasts cross the midline (over the breast bone) and are connected. You appear to have cleavage but the implants are just very close in the midline. This is its own issue, but isn't true symmastia. With a physical exam, we could better determine is your implants are actually crossing the midline. Regardless, you have very large implants in place. When you have a large implant for someone with a small chest/body like you, the base diameter (width) of the implant will be very wide. This will mean that it spreads out over your chest and touches in the midline. If you are looking for a more natural appearance, I would suggests going with a smaller implant. 800 cc is very large and is going to really stretch your skin over time. A smaller implant will give you a more natural appearance. A smaller pocket will need to be created for a smaller implant and that can help adjust where the implant sits. If you have had 3 surgeries from the same person and have continued to be unhappy, perhaps consult with another plastic surgeon near your area to see what he/she has to offer. The best way to guide you is with a consult and physical exam. I wish you all the best,Dr. BlaggAustin, TX

Ross Blagg, MD
Austin Physician
5.0 out of 5 stars 18 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.