Can an internal bra help fix congenital symmastia WITHOUT implants? How much for an internal bra?

Question

I have congenital symmastia or a natural uni-boob that seemed to worsen significantly after breast-feeding. Some Doctors recommended I do implants plus Liposuction over the sternum. Another suggested I do a lollipop breast lift. Not only do my breast connect but I'm concerned that liposuction alone may stop skin tenting. My question is with maybe just the breast tissue I have, could liposuction and an internal bra lift my breast and separate them without lollipop scars and without implants?

Daniel Barrett, MD · Answer

Hi MichaelJacksonBADD, 
  
Symmastia is a rare breast condition that occurs when soft web-like breast tissue pulls breast tissues towards each other, until the breasts meet uncomfortably at the center of the chest near the sternum (the body’s midline point). Given this abnormal union, symmastia is known by many other names, including breadloafing, kissing breast implants, and the uniboob. 
  
Unfortunately, this condition causes the surrounding skin and pectoral muscles to literally lift off the breast bone as the implants are pulled together. This consequently causes pain and discomfort, as well as obvious distortion of the breasts, which can only be disguised with clothing that does not show cleavage.
  
You should consult with a board certified plastic surgeon for proper assessment. Only after a thorough examination you will get more information and recommendations.
  
Daniel Barrett, MD, MHA, MS
  
Certified, American Board of Plastic Surgery
  
Member, American Society of Plastic Surgery
  
Member, American Society of Aesthetic Plastic Surgery

Zoran Potparic, MD · Answer

Symmastia is very difficult problem and may require different approach to every patient. In particular a congenital one. My inclination, based on your photos and short of in-person evaluation, would be to treat it with shaping of breast by means of liposuction, placement of few deep sutures which will fix skin to the sternum and ribs (bone); symmastia bra with a spacer to provide pressure and support fixation should be part of this treatment. This can all be done in local anesthesia. Good luck.

Jeffrey Ditesheim, MD, FACS · Answer

It sounds like you have had a few consultations with different recommendations.  Welcome to the world of plastic surgery.  As you know symmastia is a difficult problem to "fix".  As such there are different recommendations.  It is also not a common problem so no one plastic surgeon will have extensive experience.  Finally, each patient is different.  When you say that this is "congenital symmastia" does this mean you have real breast tissue under the sternum?  Or that this problem has been present since you developed breasts or only after nursing?  These are all important pieces of the puzzle in know in how best to make a plan to help you.  Understanding why you have this anatomical challenge is paramount in deciding how to correct it.

Kevin Tehrani, MD, FACS · Answer

Thank you for your question and posting an appropriate picture. You are a good candidate for a breast lift and internal bra using Galaflex 3-D mesh.  You only need an implant if you wish to have larger breasts, however, you look like you have good volume and don’t necessarily need any additional.

Soumo Banerji, MD · Answer

Thank you for the interesting question and picture.  I would recommend starting with the simplest possible procedure that will have the fewest scars and potential for complications.  This would be liposuction followed by use of a "thong" bra for 6-12 weeks to compress the area and help the skin shrink back down to help define the space between your breasts.  The "internal bra" may be an option, but will require much larger scars beneath your breasts as well as placement of a foreign "mesh" inside your breast with its own potential for complications.  Again, I would say to start with the simplest solution first as liposuction alone has minimal risk, could possibly be done even under local anesthesia, and is relatively inexpensive compared to other treatments such as the "internal bra".  Hope that helps and good luck!

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