Do I have symmastia? And if so, is my condition bad? (Photo)

I went in for a breast augmentation and got 525 cc. However I did not have a nice appearance of cleavage so I went back to get them done larger. I currently have 800cc silicon implants & I still do not have the cleavage appearance I desired. My breasts are low set and my surgeon did mention this to me. I do not know how to fix my problem.

Doctor Answers 10

Low positioned breasts

require elevation of the pocket and a lift to elevate the nipple with the mound.  Smaller implants may be needed to allow for this and consideration of shaped textured implants may be needed.  Your problem is challenging to repair and you may have to compromise on you expectations to just have a better look.  Your implants are so low that the muscle (if it was placed under the muscle) isn't even providing any coverage.

Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

Breast implants

Thank you for your question and photos.  It appears that your breasts are very low on your chest, requiring a breast lift/pocket revision/smaller implants.  By dissecting closer to your sternum to improve cleavage, your nipples will only move further to the sides of your breasts.  If you leave your breasts as they are now, they will only continue to sag more with time. 

All the best,

Dr. Results
Miami, FL

Jose M. Soler-Baillo, MD
Miami Plastic Surgeon
4.7 out of 5 stars 92 reviews

Smaller implants and a lift

Think you for your question.  You do not appear to have symmastia, however you have extremely large implants for your size and very little support in the lower pole which is causing the bottoming out further. With your pocket dissected so far medial although without symmastia and with bottoming out this has caused her nipple to be positioned upward and outward. You should consult with a board certified plastic surgeon articulating your desired look and possibly showing photographs of the desired look you seek. Many patients imply closely set implants to accentuate cleavage however this can cause the nipples appear artificially laterally displaced in the frontal view.

Wesley G. Schooler, MD
Santa Barbara Plastic Surgeon
4.8 out of 5 stars 17 reviews

Does Patient Have Synmastia?

Consult with a board-certified plastic surgeon who can examine you, assess the pockets. It is possible to tailor the pockets of the breasts, but it's a more complex operation than the initial breast augmentation. The large size of your implants may be contributing to some of the issues you mention, so weight the possibility that a breast revision surgeon might suggest doing down in size.

For more information on breast revision, click on the link below.

Heather J. Furnas, MD
Santa Rosa Plastic Surgeon
4.9 out of 5 stars 30 reviews

Problems with breast implants

Now that you've had 2 surgeries and have obvious pocket problems, it will be very hard to get what you want. Please make sure your surgeon is qualified and very experienced and up to that task. You might need to meet with some others before proceeding.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 67 reviews


Thank you for the photos but an examination and thorough discussion of how you would like your breasts to look is really needed before making suggestions so see some experts in your area 

Dr Corbin

Frederic H. Corbin, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 62 reviews

Do I have symmastia? And if so, is my condition bad?

Thank you for your question and photos.
I am sorry to hear about the complication you have experienced. From the photo, it looks like you may have implant malposition; both inferiorly (bottoming out) and medially (not necessarily symmastia).    

Successful correction of implant malposition, in my opinion does require some experience; I would suggest that you do your due diligence when it comes to selecting your surgeon for this type of revisionary breast surgery.

In my practice, having used a variety of “techniques” for correction; I find that the most reliable technique involves capsulorrhaphy ( internal suture repair of the breast implant pockets along the cleavage area). Sometimes, the use of acellular dermal matrix is helpful also. Often, it is necessary to “open” the breast implant pocket laterally (outer breast fold) to allow for positioning of the implant centrally behind the breast mound. This maneuver may also decrease the amount of implant pressure against the medial suture line. 
You may find the attached link helpful to you as you learn more about the options available.  Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,499 reviews

Is your ideal cleavage 1 or 2 fingerbreadth?

First, define your ideal cleavage.  Should there be a space between the inner breasts? Second, define your ideal breast position.  Would you prefer more volume higher up, between the collar bone and nipple?  Third, how motivated are you to undergo another operation?  Symmastia is a condition where there is a communication between the right and left breast, i.e. "uniboob".  It's not dangerous but cosmetically unappealing.  Repair solutions include: 1. change of implant position (subglandular to subpectoral); 2. suture repair with permanent stitches; 3. reinforcement with ADM (Strattice) would restore a space between your breasts, provide a "sling" for the implant and help with implant malposition.  All these strategies will need to be combined with switching the implant to a smaller volume and foot print, in order to avoid excess stretching of your breasts.  good luck.

Lavinia K. Chong, MD
Orange County Plastic Surgeon
4.8 out of 5 stars 58 reviews

Symastia in big implant breast reagmentation... What to do next?

I am sorry that you are having concerns about your procedure and thanks for sharing your question. I can appreciate your concern.

Your cleavage line seems well defined, making the communication between your 2 breasts (symmastia) unlikely.

I gather that your ideal breast is higher and perkier. Then the solution is going to be to reduce the implant size, reinforce the bottom of the breast with a sling, and do a lift to readjust the breast to the new implant position.

Finally, make sure that you have a consultation with a board certified plastic surgeon that specializes in breast revisions.

Wishing you the best in your journey

Not symmastia but malposition

By definition, symmastia involves communication between the two pockets and it appears that you still have tissue separating your breasts. Whether this is just skin or there is some muscle is tough to tell based only on your pictures. In any case, your breast implants are malpositioned relative to your breast and nipple.  You may very well need a muscle repair over your cleavage area to give you back "normal" cleavage between your breasts. I would speak with a surgeon with experience in this area (breast augmentation revisions). Good luck

Robert Frank, MD
Munster Plastic Surgeon
5.0 out of 5 stars 35 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.