3 weeks post-op BA, is this symmastia? (photo)

I am 3 weeks post op (325 & 350 round mentor implants). My sternum swelling initially went down, but now it's swelling again. I want to know if it is symmastia. Also, I noticed a supraclavicular lymph node swollen on my right side, and the doctor told me there is also an axilary nose palpable.

Doctor Answers 13


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it is difficult to tell based on your photos and it is too early in your postoperative period to know for sure. best to see your PS and discuss. 

3 weeks post-op BA, is this symmastia?

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Thank you for your question. Remember, it is best to be seen in person by a double-board-certified plastic surgeon for precise diagnosis and treatment.

Moneer Jaibaji, MD
San Diego Plastic Surgeon

Possible Symmastia at 3 Weeks Post-Op

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1.    pain is variable

2.    it takes 2-3 months for implants to settle and muscles to relax

3.    celebrex, motrin, and muscle relaxers can help

4.    massage and stretching may help

5.    everyone heals differently

6.    4-7 days off from work is common

HEALING OF SENSORY NERVES: Tingling, burning or shooting pains, which will disappear with time and should not alarm you, indicate regeneration of the sensory nerves. If these sensations cause pain, repeated, local self-massage helps.

ASYMMETRY: The two breasts commonly heal quite differently. One breast may swell more, feel more uncomfortable, or have a different initial shape. After complete healing, they will be more similar and natural. You must have patience, but if this causes concern, ask questions of the doctor or the nursing staff.

SHAPE AND CONTOUR: The final shape of your breasts will start to look its best approximately three (3) months after surgery. It takes time for the skin and muscle to stretch and relax around the new implant. The breast will often look higher, firmer, and “less natural” in the first three (3) months. It can take up to a year to see your final result.

FOLLOW-UP EXAMS: These are generally done in 1 week, 2 to 3 weeks, 3 to 6 weeks, 3 months, 6 months to 1 year, and 1-2 year intervals. In our office we include all of your follow up appointments in the initial surgical fee.

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

Possible fluid collection

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This is a very good question that will be relevant to many women who undergo breast augmentation. I agree that you should see your plastic surgeon as soon as possible to rule out a possible hematoma vs a seroma. Although a hematoma would be unusual so long after surgery if activity restrictions were maintained and with no history of trauma, it has been known to happen. 

As you nicely point out there is clearly an asymmetry and hematoma and seromas need to be ruled out. This can be done by seeing your plastic surgeon.

Good luck and good health!

Amir Nasir, MD
Westport Plastic Surgeon
5.0 out of 5 stars 2 reviews

3 weeks post op, some advices:

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Thanks for the question. I recommend you to see your plastic surgeon as soon as possible and follow his advices. Kind regards 

Emmanuel Mallol Cotes, MD
Dominican Republic Plastic Surgeon
4.7 out of 5 stars 365 reviews

3 weeks post-op BA, is this symmastia?

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Thank you for your question.  Based on your photograph you are at risk for symmastia.  See your plastic surgeon and ask for advice on wearing a "symmastia bra".


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It appears that there is some swelling between the breasts and a vague distinction there. Although it doesnt appear to be symmastia, it might help to wear a special bra that applies some pressure between the breasts such as the ThongBra or similar. I would schedule frequent visits to your surgeon to make sure that things are progressing as expected.

Best of luck recuperating,

3 weeks post-op BA, is this symmastia? (photo)

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Thank you for sharing your question and photograph.  Though nothing replaces an in-person examination, it appears that there is a distinct plane between your breasts, and as a result I do not think you have synmastia.  You do have some asymmetry between your breasts, as well as soft tissue swelling that is likely accounting for your current differences.  This should resolve/improve with additional healing time.  Hope this helps.

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 80 reviews

Not Symmastia

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You don't appear to have symmastia as you have good medial definition at your sternum. You probably still have some swelling. Even though your initial swelling went down, it is normal to have some residual swelling for 3-6 months. In addition, your implants are riding a little high and medial, which will settle over the next 3-6 months as well. As mentioned by others, you should follow closely with your plastic surgeon with any concerns. 

David Graham, MD
Rochester Plastic Surgeon
5.0 out of 5 stars 9 reviews

Breast augmentation

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Thank you for your question and photograph.

It does not appear to be symmastia but there is some asymmetry between the breasts. At 3 weeks post op this could just be due to swelling resolving but I would recommend scheduling an appointment with your surgeon to have an examination and discuss your concerns to rule out any potential complications. Best of luck in your recovery.

James Fernau, MD, FACS
Board Certified ENT
Board Certified Plastic Surgery
Member of ASPS, ASAPS, ISAPS, The Rhinoplasty Society, AAFPRS, OTO/HNS, ASLMS, International Federation for Adipose Therapeutics & Science

James Fernau, MD, FACS
Pittsburgh Plastic Surgeon
4.9 out of 5 stars 86 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.