Should I get implants if I have congenital symmastia? (Photo)

Hi, Symmastia can certainly be made to appear less aesthetically pleasing when large implants are used. Using a smaller implant is suggested. Your surgeon would likely stay a bit farther away from that area than normal to prevent any further migration of the implant after surgery as it establishes its pocket. The implant, even if it's on the smaller size which could certainly still be very adequate, will give you improved shape in the upper portion of the breast and in the cleavage area. Good luck.

After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size and style breast implants. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon's experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what size and style breast implant is right for them. You should also be aware that results of surgery can change in the future with significant weight change and/or stretching of skin from the milk of pregnancy. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame. Philadelphia, Pa., USA.

Congenital symmastia can be difficult to treat and get aesthetically pleasing results. However, a combination of a breast augmentation with directed liposuction and fat grafting can help shape the breast to camouflage the symmastia.

Make sure to discuss with a Board Certified Plastic Surgeon with experience in the matter.

All the best.

Dear Reliable566456,
breast implant type and sizing selection is a complicated process and requires a detailed consultation that includes a discussion of your goals, a detailed examination, and a lengthy discussion. But the decision will always start and end with the patient. When it comes to sizing, we have all of our patients find 3 photos of their desired breast size. We ask for naked breast photos because clothing can obscure the true size (push up bras). Next, we consult with patients and go over the photos and take detailed breast measurements during a physical exam. Next, we using a sizing algorithm to determine a range of implants that will work based on the exam and the measurements.Lastly, during the operation, we use silicone sizers in the operating room to see how the size actually looks in the breast. We sit the patient up in the operating room, while asleep of course, and compare the sizer result with their desired look photos. If it is too small, we start the process over with a slightly larger implant. We don't stop until we get the perfect match.Of all of my breast augmentation patients, every one of them has been happy with their size due to this detailed and meticulous process. You don't want to invest time and money into a result that is either too big or too small.You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Hello, thank you for your question. I would not recommend liposuction in this area, and just go with a breast augmentation. A board certified plastic surgeon will be able to guide you to the correct size implant. Based upon measurements of your chest wall and breast imprint width as well as knowledge of all breast implant sizes and profiles should make this process easy. Try on a profile bra with various silicone cc sizers your PS recommends under a tailored blouse, tank top, bikini, workout clothes, and other garments you typically wear so that you have the best idea of whether the garments fit as desired with the implant selected. Select the size that boosts your self-esteem, and fits your anatomy. Choosing an implant based on an aesthetic goal that exceeds your anatomic capacity may lead to complications and possibly revision.

You are starting out with very pretty and symmetrical breasts. Synmastia is a variant of normal, even if you don't like it. The danger of creating a greater degree of synmastia only exists with too large, and/or too wide an implant, and your plastic surgeon would be best to determine your optimal treatment plan. In your particular case, based on your photos alone, a slightly narrower implant with slightly greater projection is more likely to enhance your cleavage without risking making your synmastia more pronounced. The idea of liposuction between your breasts only makes sense if one can appreciate an excess amount of subcutaneous fat in the area. Discuss your concerns in detail with your plastic surgeon. When in doubt, consider a second opinion from another board certified plastic surgeon. Best of luck to you.

Good morning!
It's definitely a tricky situation to consider- most surgeons would choose to just do an augmentation, not release the muscle medially, so that your congenital synmastia is camouflaged but won't actually improve. Liposuction is another approach, but there are dangers in this- if your skin doesn't "stick back down" after the fat is removed between the skin and the breastbone, the synmastia will actually get worse and the tenting is more obvious. I vote for straightforward augmentation and no liposuction based on your photos.

Thank you for sharing your question and photographs. Assuming you select well-sized implants for your breasts I do not think your results would be made worse with an augmentation. Hope this helps.

Just based on your photos, I would suggest leaving the cleavage area alone and just get implants. The center chest is not a very forgiving area to treat with liposuction, and your vertical photo looks fine. The size you have selected should look very nice.