Am I Starting to Develop Symmastia? Are Implants Too Wide? (photo)

5 months post op my implants cause the sternum skin to raise when I wear a pushup bra. When I bend over they come too close to eachother and laying on my side they push eachother so much that my sternum hurts but when Im standing theres no uniboob. My ps told me that I need NOT to wear bras that push them together and also to use a pillow when I lay on my side. He said that overtime they will make the pocket larger and will get symmastia. I asked if he created the pocket too big and he said no.

Doctor Answers 9

Breast Augmentation Patients Should Wear Any Bra They Want...

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

It amazes me that plastic surgeons have invented bras to suit the needs of their breast augmentation patients.  In my opinion, something went wrong if a breast augmentation patient can't wear a regular bra.

It's impractical for a patient not to wear a bra she wants, particular a push-up bra for a patient who wanted to have an operation ostensibly to have larger breasts.

But perhaps your surgeon thinks your tissue is still settling and wants to not put pressure on it.  So listen to all of his or her advice at this point.  Once you get out to a year, then you need to reassess as to whether there is a problem to fix.



Los Angeles Plastic Surgeon
4.6 out of 5 stars 49 reviews

No signs of symmastia

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Looking at your pictures, it does not appear that you have any symmastia or "uniboob". There are appliances that you can put between your breasts at night, to keep them apart if you are worried. But overall it seems that you have a symmetric breast augmentation. Hope this helps..

Dr C

Ritu Chopra, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 34 reviews

Symmastia and larger pockets

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

do not go hand in hand as your surgeons suggests according to your post.  But as mentioned, your implants are close together.  Everyone has different ideas of what they like and if you like what you see, I wouldn't worry.  Symmastia is only a word defined as the breasts coming together to create one larger mound.  If you wish to have more space between your mounds, you will have to see your surgeon (or another one) who can provide you with your options.  Good luck!

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

About Symmastia with Breast Implants

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Symmastia is a condition which can occur when the implants are too close together. Patients often refer to this as a “uniboob.” Occasionally, the space or pocket for the breast implant is created towards the center, or the tissue stretches, forcing  the implants to fall too much towards the center of the breasts. However, #symmastia is not apparent per your photos at this time.  If you are not satisfied with your #final #results or if there are any concerns, it's best to consult with your plastic surgeon to further discuss your #options.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

Symmastia and its causes

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Technically, symmastia means the two breasts are connected (or the implant cavities are connected). You don't have this yet but I don't think any external devices or maneuvers will prevent it. 

The factors that predispose to symmastia include, implants above the pectorals muscle, over-dissection of the medial side of the pocket for the implants, an implant that is too wide to fit behind the diameter of the breast, and alteration (usually surgical) of the capsule on the medial side of the breast.

If breast implants are properly sized to the width of the breast and positioned correctly below the pectoralis muscle without over-releasing it on the medial edge of the breast, they should not become connected in the center regardless of activities or garments. This is why the gap between the breasts should stay the same after augmentation even if the "cleavage" or slope at the medial edge of the breast increases. Preoperative pictures would address whether the implants put in were too wide for the space behind your breast. 

Correcting symmastia is quite difficult unless the implants are above the pectoralis muscle and can be changed to a subpectoral position with a neo-capsular pocket. Creating a new medial border for the implant with dermal grafts is the other option and not a simple correction. 

Scott L. Replogle, MD
Boulder Plastic Surgeon

Am I Starting to Develop Symmastia? Are Implants Too Wide?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

In my opinion based only on the posted photos you do not have symmastia! As for the lateral displacement ONLY in person examination could determine this. 

Close but not symmastia

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

The space between your breast is narrow but does not yet fit the definition of symmastia.  Presently, you are 5 months following surgery.  It is worthwhile to try external garments to maintain the space between the breast in hopes that it will allow tissues to mature and stop progression of the pocket stretch.  If rippling is a concern then revision with silicone if you have saline can be considered along with pocket tightening (capsulorarrhpy) and dermal matrix reinforcement should be considered.

Chen Lee, MD
Montreal Plastic Surgeon
5.0 out of 5 stars 21 reviews


{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Certainly when the implants are pushed together you have symmastia.  One solution may be to place the implants underneath the muscle or to fic the pocket.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews


{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Hi JJ479,

     The space between your implants is way too small.  It appears, however, that there still is some skin attached to your sternum in the midline, so technically, you do not have symmastia as of yet.   Regardless, you have very little soft tissue covering the implants in that area where rippling is visible, particularly when you bend over.  I'm not sure if you are under or over the muscle, and it would be nice to know if you have saline or silicone gel implants.  Regardless, your implants should  to be moved apart.  Most like, this will require revision surgery.  You may, however, want to try to wear a "Thongbra"  for a while and see if that will help close the pockets.

Good luck,

Ary Krau MD FACS


Ary Krau, MD, FACS
Miami Plastic Surgeon
4.7 out of 5 stars 358 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.