Symmastia or tenting? (Photo)

Good afternoon,
I fix a LOT of synmastia and it comes in many types. Going back to your never had surgery breast state, did you have some squishy subcutaneous fat between your breasts then, or was there a well-defined midline? Pre-pre-BA photos would help. But short answer is yes, this can be corrected- it's just not your every day run of the mill plastic surgery operation however, and many plastic surgeons will finish their career having NEVER repaired a synmastia case, so look before you leap- make sure you choose a VERY experienced revision surgeon who can show you many many many pre- and postop photos of their own work where they have successfully corrected synmastia before ever considering allowing them to try to fix yours.

Unfortunately, the midline can be affected by implant style, size, existing anatomy. A surgical revision may be indicated.

Large base width implant placed far toward the midline can result in tenting. This is where the middle skin is raised. Changing for a narrower or higher profile and/or smaller cc may help. Some pocket adjustments may be needed.

In true symmastia, the pockets connect across the midline. If this is present, usually biologic mesh is needed to separate the sides.

Repeated consultation with your or a plastic surgeon is recommended to further assess and advise your situation.

You do have symmastia and the nipples are pointing outward. The technique I recommend is a mini lift. Using a circumareola incision, your breast tissue is reshaped, elevated higher on the chest wall and more medial to increase your cleavage. At the same time, smaller implants can be placed totally submuscular.

Best Wishes,

Gary Horndeski, M.D.

Dear madaron,
symmastia is a rare breast condition that occurs when soft web-like breast tissue pulls breast implants 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
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Thank you for your question. A large portion of my practice is dedicated to revision breast surgery. There is no question that you do have symmastia, but also have breast ptosis with your areolas pointing too far to the side. I believe that you would benefit from symmastia repair, i.e. capsulorrhaphy and a breast lift-lollipop mastopexy to elevate your areolas and bring them more to the center. In fact, I wrote the first paper on capsulorrhaphy almost 20 years ago. Additionally, by bring the implants more laterally and fixing the symmastia, this will make the areolas appear more to the center. Definitely search for plastic surgeons with extensive experience with breast revision and symmastia repair. Best wishes to you.

Thank you for sharing your question and photographs. There is certainly good concerns for possible communication of your implant pockets over your breast bone. Best identified with an in-person examination but I would seek second opinions if you have lost faith in your surgeon.

Yes, this is fixable, but I would suggest changing your implant to smooth round with a smaller width as well as tightening your medial pockets. Your implant base is probably too wide.

Madaron,
Of course an in office examination would diagnose what is going on. It appears that you do have a symmastia which would require a surgical correction. Get copies of your surgeons operative notes and pre-op photos for your surgeon to evaluate.
Dr. T

Thank you for the question and photos. Though an examination is really needed, if you have symmastia it can be corrected. So get your records and preop photos and go on some consultations with experts and compare recommendations after a full examination and look at photos of similar patients and become fully informed about the desired procedure

Dr Corbin