325cc, moderate profile, implants very close & ache sometimes, do I have symmastia? (Photos)

Question

Hi there I have 325cc moderate profile. My implants are very close and ache sometimes. I have recently been away and in certain pictures it looks like I have symmastia. They don’t look good they look saggy and just not right centrally. My surgeon disagrees and states I have a good result.

Semih Yildiz, MD, FEPOBRAS · Answer

The photos show a very narrow central cleavage area and some lower-pole fullness/settling, but they do not prove true symmastia by themselves. True symmastia means the normal central attachment of the breast skin to the chest wall has lifted and the implant pockets communicate across the midline; that requires an in-person exam.

Because you have aching and you are unhappy with the central appearance, it is reasonable to return to your surgeon and also consider an in-person second opinion from a board-certified plastic surgeon. The exam should assess implant width, pocket position, capsule, tissue stretch, and whether bottoming out or breast ptosis is contributing to the saggy look. If there is confirmed pocket malposition or symmastia, correction is usually surgical and may involve capsulorrhaphy/internal support, implant size or profile change, and sometimes a lift, but the plan depends on your tissues and timing from surgery.

Chul Hwan Seul, MD, PhD · Answer

I have a mild suspicion of symmastia, but a thorough examination is needed to confirm its presence. It's important to note that even if mild symmastia is detected, a reoperation may not be necessary if there are no significant cosmetic concerns. However, if you are experiencing substantial cosmetic issues and are highly dissatisfied with the appearance, you may wish to consider the option of reoperation.

Daniel Barrett, MD · Answer

Dear denver1994,
I understand your concern. Based on your photos, it looks like you don't have symmastia. However, without a proper assessment, it would be difficult to determine what went wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Zoran Potparic, MD · Answer

Based on these photos you have symmastia. Second opinion consultation with another board certified plastic surgeon with good reputation in breast surgery is recommended. Good luck.

Camille Cash, MD · Answer

From the submitted photos it does not appear you have symmastia.  The discomfort you describe could be related to a variety of things.  If your surgery is recent you still may be recovering.  It could also be due to hormone fluctuations throughout the month.  I encourage you to discuss your concerns with your surgeon.

Connie Hiers, MD, FACS · Answer

For the size you picked, they are fine. However, a smaller size implant would fit your frame and tissue better.

Mats Hagstrom, MD (license on probation) · Answer

To make a quality assessment regarding the outcome of a plastic surgery procedure we generally need to see standardized, proper before and after pictures. If you don’t have your before and after pictures, then ask your surgeon to forward the pictures they took. Standardized pictures with your arms down by your sides, showing frontal three-quarter view and side views are ideal.
It does not appear that you have symmastia, and most patients prefer to show cleavage. Some women have breast that naturally said close together, while other women have breasts that are naturally more divergent.
If you’re not happy about the results, then it’s important to state clearly what you don’t like about the outcome.
Results always need to be taken in reference to what you look like before the procedure so including before and after pictures is key to making a good assessment and giving quality recommendations.
Follow up with your provider or schedule in person second opinion consultations with other plastic surgeons in your community.
Best,
Mats Hagstrom, MD

325cc, moderate profile, implants very close & ache sometimes, do I have symmastia? (Photos)

Answers (7)

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