How do I know if I have symmastia or just swelling after surgery?

I had a breast augmentation about a week ago? I am a very small framed women and got the biggest implants my surgeon would allow. 400cc but now I am worried that I have developed symmastia? I called my surgeon and was told they have never had that happen and it is probably just swelling from surgery but I would like to get ahead of this problem, if it is a problem. My breast are still very swollen but the skin in between my breast is slightly raised and I can push it down to my sternum?

Doctor Answers 5

You need an examination to diagnosis symmastia

Thank you for your question.  It is impossible to answer your question without at least a photograph.  You will need examination by your plastic surgeon to enhance your question fully.  It is not uncommon for the chest to be quite swollen after breast implants but if the skin is detached from the breast bone and you can push your implants to the center and they meet and touch then you may have symmastia.

Symmastia from big implants

If the implant is larger than the available skin envelope then the skin will raise early after augmentation. Symmastia occurs if the pocket tears or shifts allowing the implants to run together in the middle. Pressure over the breast bone with additional padding in your bra might help as the skin envelope begins to relax.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.1 out of 5 stars 40 reviews

How do I know if I have symmastia or just swelling after surgery?

Your description of “skin in between my breasts is slightly raise” does not sound consistent with symmastia. Unfortunately, there is no way of getting ahead of this potential problem, if it were to arise. You may wish to discuss the use of a “symmastia bra” with your plastic  surgeon;  this "bra"  applies pressure to the sternal area.  Its use may, at least, give you some peace of mind. I hope this, and the attached link devoted to symmastia correction ( also demonstrates the use of the bra) helps.

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Symmastia or Swelling after Breast Augmentation

Your description of the early results of your breast augmentation procedure sound more like swelling and not symmastia. It is very common to have swelling that crosses the sternum in the early period after breast augmentation surgery.

Synmastia vs. Post-op Swelling

Following breast augmentation, post operative swelling can certainly involve the skin and soft tissues over the sternum. But this swelling does not represent synmastia. Synmastia is when both breasts meet/touch in the midline; it is more common when large implants are used. Following subglandular augmentation, this would occur immediately following surgery if the pockets were dissected too far medially on both sides; or it could occur in a delayed fashion if the medial pocket dissection was in close proximity and then stretched or tore, allowing the implants to move together in the midline. Following a subpectoral augmentation, synmastia is less likely to occur because the implants are placed below the muscle. However, if significant release of the medial muscle origins was performed, the implants could move medially and synmastia it could develop. Synmastia is usually a problem that would require surgical correction.

The fact that you describe "the skin in between my breasts is slightly raised and I can push it down to my sternum" would suggest that there is a space between the implants.

Swelling between the breasts will improve with time. If you would like this to improve more quickly, then the use of some additional pressure/compression in the sternal area would be helpful.

Best wishes. Ken Dembny


Kenneth Dembny, II, MD
Milwaukee Plastic Surgeon
4.9 out of 5 stars 34 reviews

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.