Separation Between Augmented Breasts Was Perfect Until 5 Mo After Surgery - Now I Have Uniboob? (photo)

My March '12 aug gave me nice, full C cup breasts. Around the 5th month, my cleavage seemed to disappear overnight and now I have what I believe to be symnastia. Is this common to occur this long after surgery(10/12) I can't wear triangle bikini tops or any open shirts or dresses, which was my original goal and reason for having surgery to begin with. I want to bring this up to my surgeon, but I feel very uncomfortable being confrontational.

Doctor Answers 7

Uniboob After Breast Augmentation

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It is truly difficult to tell from your photos. The cleavage is defined by where the pectoralis muscle attaches to the sternal bone. Some patients have a very close distance and some have wider distances. It is certainly possible that the implants are crossing the midline and touching but it does not seem that way from your photos. Do not feel scared to discuss this with your surgeon. Your choice for your particular surgeon should have been based on the trust you have for that person to compete the job as you desired pre-operatively. Be up front with your surgeon. It is the best policy. 

Synmastia or UNIBOOB after surgery

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Thanks for the photographs. an examination at this time will give me abetter understanding of what is going on.I tell my patients that cleavage is and cannot be created by implants but they can be created by bras. With a better understanding of what your height, weight, chest wall size and breast width preop, you can be sized with implants of a different shape and size that better fit your expectations and needs. 

Norman Bakshandeh, MD, FACS
New York Plastic Surgeon

Separation Between Augmented Breasts Was Perfect Until 5 Mo After Surgery - Now I Have Uniboob?

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Thanks for the posted photos. Very hard via the internet to determine if you do have a post op symmastia. By definition the two implants should be in "direct" contact. Very hard to determine that. Also are you under or over the muscle?? In my opinion you need in person second opinions and yes see your surgeon. 5 months post op occurrence very unusual. 

Your implants are too big for your chest

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Your picture post op shows that implants are placed too close to mid-line and possible above the muscle. The larger the implant base, larger the risk of symmastia. your implants are too for your breast tissue and there is no room except pushing toward each other. You need to see your surgeon and discuss your concerns.

Discuss concerns with your surgeon

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It is difficult to determine from your photographs whether or not you have synmastia, but they do appear fairly close together.

It is very important to discuss any concerns you may have about your surgery with your doctor. They are in the best position to evaluate your progress. If you are unable to get a satisfactory answer from them, then seek a second opinion from another board-certified Plastic Surgeon.

Synmastia vs malposition

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judging from your pictures it appears your implants  are not centered behind your areolas. This may be fixed by opening up the lateral portion of your implant pocket and closing off a portion of the medial portion of the pocket. Share your concerns with your surgeon and if the answers you are getting are unsatisfactory get a second opinion. Good luck!

Marcel Daniels, MD
Long Beach Plastic Surgeon


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I am looking at what appear to be rather large implants that still have a distinct separation between the two. The photos are dissimilar enough that it makes it hard to compare and see if there has actually been a change. 

To meet the definition of symmastia after breast augmentation, the implants would be touching, and there is still a clearly visible demarcation. 

If you don't like the current appearance, by all means do discuss the issues with your surgeon. A recommendation for improvement will likely include switching to a smaller size of implants. 

Thank you for your question, and for the attached photos. Best wishes. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

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.