Can I get Breast Implants without Symmastia being a problem? (photos)

My breasts never touched. Ever. But after my second pregnancy I did notice that I have some loose skin in between my breasts. It isn't attatched to the bone. While I was pregnant everything was fine. I think it is from the sagging of my heavy breasts from the milk. I did not breastfeed. What if your opinion? I am 5'3 145lbs. I was told I have a lot of good fat and tissue. I was looking to get 540cc saline under the muscle.

Doctor Answers 10

Implants not recommended

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Your breasts are large enough and you do not need implants.I recommend a new technique called The Ultimate Breast LiftTM.Your breast tissue is reshaped creating upper pole fullness, elevated higher on the chest wall and more laterally to decrease the symmastia.Unfortunately, you have not told us your bra size but 540 cc implants will not fit retro-pectoral, will extrude inferiorly and laterally requiring revision.

Best Wishes,

Gary Horndeski, M.D.

Breast Augmentation under the muscle

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I agree with other authors that a properly done sub muscular breast augmentation should not create true symmastia.  The medial aspect of the pectorals major inserts into the lateral side of the sternum, preventing the implants from touching.  However, two large implants may push the medial breast skin forward and stretch the skin between them.  It is possible that you get some degree of "pseudo-symmastia" as a result.  I would suggest you bring this up with your surgeon to consider all options prior to surgery. 
Dr Rodger Shortt
Oakville Plastic Surgeon

Risk of symmastia

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Placing implants under the muscle will not result in symmastia, because the attachment of your pec muscle to the breastbone will stop the implants coming together in the middle.

Roy Ng, FRCS(Plast)
London Plastic Surgeon

Can I get Breast Implants without Symmastia being a problem? (photos)

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Having a large implant place sub muscular would most likely hide the symmastia effect you show here.... 


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Some patients have a natural fold of tissue like you in the central chest. Implants placed under the muscle will not lead to symmastia unless the msucle medially is completely violated.


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Thanks for the detailed photo.  I have treated a patient with a similar appearance in the past.  The risk of symmastia is minimal.  I used submuscular implants. You have the appearance of symmastia now but this will not appear any worse with implants.

Symmastia is a surgical error

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You have an interesting fat distribution between your natural breasts. Any good plastic surgeon can put implants beneath the muscle with minimal risk of symmastia. A small strip of muscle is left attached to the chest wall and prevents symmastia. The fat  between the breasts should neither get better or worse with this surgery.

Concerned re future symmastia

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Thank you for your question about your breast augmentation.

  • This is an important question.
  • It seems likely the lack of separation between your breasts is a change of fat distribution from pregnancy,
  • This should not make you at greater risk of symmastia,
  • Which is implants which are placed or move across the chest bone to touch,
  • Symmastia results from the surgeon going too far onto the chest bone at surgery
  • Or the implants being too big and moving in that direction from internal pressure.
  • A 540 implant is a large one - be sure that your chest width will accommodate the implant with room to spare.

Hope this helps. Best wishes.

Well I have symmastia following breast augmentation.

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  • From your photographs it appears that you have a degree of semester presently. With large implants under the muscle or above the muscle this may accentuate that appearance. It would be necessary to examine you to clearly give you your best options. I would recommend that you seek consultation from a board-certified plastic surgeon to determine what options would be best for you. Good luck!

William G. Hart Jr., MD
Saint Louis Plastic Surgeon

Symmastia Possible?

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Send mastery is an issue where you actually have one large breast pocket. You have anatomically close breast. If you were to get an augmentation you have fullness and they still would be anatomically close but not one breast.

Earl Stephenson, Jr, MD, DDS, FACS

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.