Am I Beginning to Develop Symmastia? (photo)

I am just over 3 months post op and I know I have "double bubble" under both breasts. I am currently waiting to see if they stretch out and look better after time. But now it looks as though the weight of the breasts is causing the tissue between them to stretch and raise....what do you think? If so should i get this taken care of right away or is it okay to wait the 6 month mark for a revision? Thanks in advance!

Doctor Answers 8

Bottoming out

The "bottoming out" phenomenon or "double bubble" that you see will almost certainly require another surgery to fix. It will not improve with just time. The timing of the surgery really does not matter, in my opinion. Choosing a smaller implant would probably be a great idea, but not absolutely necessary. I would complete a capsulorrhaphy procedure on both the medial and inferior walls of your existing implant capsular pocket. I have not seen the need to spend the money on acellular dermal matrix products such as strattice with my patients, although it certainly can be used. 

Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 80 reviews

Double Bubble


Although your breasts are very close, I don't think you have synmastia.

You correctly have pointed out that you do have a double bubble deformity. This won't correct itself without surgery. Having said that, I wouldn't jump into a revision operation just yet. Wait around 6 months until all the soft tissues have settled. This way the revisional surgery is easier and more predictable.


I hope this helps and good luck.


Implant Bottoming Out and Symmastia Correction

True symmastia you do not appear to have but it is close. The bottoming out of the implants does exist and will not improve with time and is a surgical issue. Whether you opt to widen the space in your sternum when you correct the implant bottoming out will require use of implants with a more narrow base and dermal grafting. Either issue can wait until 6 months after the initial procedure if your desire.

Am I Beginning to Develop Symmastia?

As you noted the double bubble is present on both sides, and this will require surgery. 

The implants are rather close to each other but are not touching, which is the definition of symmastia.

At the time of revision, smaller implants should be considered, as well as narrower implants. Strattice to support the repairs of both the lower and central parts of the pockets would be a good addition. I don't see an advantage of waiting 3 more months. 

All the best. 


Breast augmentation issues

It looks like you have a double bubble and will need the lower capsule corrected and support placed along the inframammary fold. Perhaps the implants are also too wide for you?  This may give you the narrow sternal space.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

Problems after a breast augmentation

You have two obvious problems, the implants are low with a visible crease across the bottom and the implants are very close together in the midline.  Neither problem will likely correct themselves.   I would suspect that eventually you would need to have smaller implants the inferior capsule raised and the space between the breast widened. This may require the use of Strattise.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 16 reviews

Synmastia after augmentation

Dear Busymom.  It's hard to know whether the weight of your implants is causing the synmastia or if the pockets were overdissected medially.  Either way, this is unlikely to get better and very likely to get worse.  A good supportive bra will help, but not the kind that pushes your breasts together.  You may even want to wear it at night.  Discuss your concerns with your plastic surgeon and consider getting a second opinion.  Hope this helps.

A surgical revision will be required to correct this breast augmentation result.

Both breast implants are well below the infra mammary fold.. This will not improve with time and will require an operation if it is to be changed.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 32 reviews

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