6 months post op Breast Augmentation, my chest muscles tighten and my implants move laterally. What leads to symmastia? (photos)

The reason for symmastia is the desire of patients to be very large with very close cleavage.  The surgeon would then need to dissect a larger pocket to accommodate the larger implant.  Often portion of the medial pectoralis muscle needs to be released to achieve closer cleavage.  Most patients then after surgery rush to Victoria Secret to get their new sexy cleavage enhancing bra which tends to push the implants closer together.  When there is little tissue separating the two implants the tissue separating the implants weaken over time.   With constant lateral pressure from the bra as the pocket heals the lateral compartment gradually closes and the medial compartment gradually expands due to this constant pressure of the bra.  Over time the cleavage is now touching.  If you insist on going very large relative to your chest frame you must not wear a pushup or sports bra.  All of these bras that are worn on a daily basis will eventually create symmastia.  There are bras such as the Thong bra or Veronique symmastia prevention bra that can help to control this phenomenon.  Before chosing such a large implant these issues should be discussed with your surgeon.  Follow up appointments are important because a knowledgeable surgeon should detect if you are at risk of symmastia. 

This a complication noticeable right after the surgical procedure. It can happens for an excesive undemining of the pocket for implants placement. You must vissit your plastic surgeon for a correction surgery.

In most cases, yours included, the cause of synmastia is the size of the implants and the need to dissect close to the midline to make room for the implants.  Many patients really want implants that are just too big for their chests and sometimes synmastia occurs or sometimes the implants settle to laterally towards the armpit.  The implant has to go somewhere.Fixing synmastia is very tricky.  I think you would need to settle for a smaller implant and possibly have some acellular dermal matrix like Seri or Strattice to help close off the medial pocket.  This is challenging surgery.You really need to go to your original surgeon and let him know that you are not satisfied.  He should not feel "bothered" but should be very willing to discuss your problem and help you come up with a treatment plan.  I don't think anyone could give you even a ball park price quote without seeing you first and coming up with a plan.

The most common cause of symmastia  is when excessively large breast implants require wide dissection close to the sternum.  Another common cause is when patients insist on having a well-defined cleavage after breast augmentation and the surgeon tries to achieve this by dissecting close to the midline..  Placing the implant pocket too close to the midline can risk of symmastia.Correction of symmastia is a very difficult procedure because re-suturing the skin down to the sternum can create retraction deformities and that repairs often fail.  Please visit your plastic surgeon and discuss your options in detail.