Symmastia? Over-dissection? What could this be? BA on 21st May. (Photos)

Question

I posted on here around 10 weeks ago concerned I had symmastia. Although my sternum swelling did settle, I feel something isn’t quite right. Naked and without a bra they are close together but I love them. As soon as I put any type of bra on they join together, there is no gap I have a uni boob. My right moves more than I feel it should, if I didn’t have a left boob I could push it all the way across my chest is how I could describe it? I had 380 moderate sudglandular from a small A cup.

Yannis Alexandrides, MD, FACS · Answer

From what you've described it does sound like symmastia which means the breasts are connected in the middle. If this bothers you, then a revision surgery would need to be done to restrict the implants from moving into the centre.

Daniel Barrett, MD · Answer

Dear jamieelise,based on your photos, there are no signs of symmastia. I understand your concern and it is quite normal to be concerned about the outcome following a breast augmentation surgery. However, you are still in the very early stages of the healing process.Your will need to be patient at this moment and follow what your surgeon has instructed you to do post operatively.At the early stage of the healing process, the tissues around the implants are still swollen. Once the swelling subsides and the implants drop to their final position, you will be able to see the final result of your breast augmentation surgery.
Daniel Barrett, MD

Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Tom J. Pousti, MD · Answer

I am sorry to hear about your concerns after breast surgery.  Although true symmastia is not present,  I do understand your concerns about the breast implants being quite close to one another in the midline.Given that you "love them" when naked or without a bra, it is probably in your best interests to avoid further surgery. However, in the longer term, if you remain concerned about breast implant positioning, you will likely benefit from revisionary breast surgery: bilateral medial breast capsulorraphy (internal suture “repair”) as well as lateral capsulotomy to improve your situation.  
In my practice, having used a variety of “techniques” for correction of symmastia, I find that the most reliable technique involves a 2 layer capsulorrhaphy (internal suture repair of the breast implant pockets along the cleavage area). Often, the use of acellular dermal matrix is helpful also. I have also been pleased with the (at least partial) correction of skin tenting that can be achieved with the use of the acellular dermal matrix.
As mentioned above, it is usually necessary to “open” (reverse capsulotomy) 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. 
It may also be necessary to change breast implant profile or volume to help prevent chances of recurrence of breast implant malposition.
This procedure will serve to improve the position of your breast implants on your chest wall, better center the nipple/areola complexes on each breast mound.
I also find that careful attention to postoperative activity restrictions is key to success with this type of surgery and other types of implant malposition revisionary breast surgery.
I hope this helps.

Antonios Mitsakos, MD · Answer

Since you went for a fairly sizeable implant that would have an effect on your cleavage as well. also some people naturally have looser skin and with the implants the definition changes

Fulvio Urso-Baiarda, MD, FRCS(Plast) · Answer

Hi Jamie,
It does look and sound like you probably have symmastia. If you love them then leave them alone! But if this is a concern for you then the correction would require further surgery. One of the relatively simple ways of correcting what can be a challenging problem is to change the implant plane from above to below the muscle, and if you seek correction your surgeon may recommend this. Best of luck!

Symmastia? Over-dissection? What could this be? BA on 21st May. (Photos)

Answers (8)

Answer: See below

Answer: See below

Answer: Symmastia

Answer: Symmastia

Recommended reading

Everything you need to know about Breast Augmentation

Our mission is to create a world where every investment in modern beauty is Worth It.

Symmastia? Over-dissection? What could this be? BA on 21st May. (Photos)

Answers (8)

Answer: See below

Answer: See below

Answer: Symmastia

Answer: Symmastia

Browse related questions

Recommended reading

Everything you need to know about Breast Augmentation

Our mission is to create a world where every investment in modern beauty is Worth It.