Symmastia: How Can I Separate my Breasts?

I was born with symmastia. I never done any breast surgery or any surgery before in my life. I'm doing some research and look at a few pictures from symmastia and realize that this is what my chest look like. I feel so uncomfortable when wearing clothes especially clothes where I have to show off my breast. NO CONFIDENCE! What are the choices for me? Can I use a thong bra to separate them?

Doctor Answers 12

Repair of Congenital Symmastia

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Thank you for the question.   There is a good solution for congenital symmastia. I use a small incision in the breast fold to repair and separate the breasts to provide a normal amount of cleavage. Other plastic surgeons advocate implants and /or liposuction but I have found that suturing the tissue works the best in my hands. Recovery and results are usually excellent. The link below shows before and after photos of a patient that underwent congenital symmastia repair by this method.

All the best,

Dr. Remus Repta

Scottsdale Plastic Surgeon
4.9 out of 5 stars 171 reviews

Congenital Symmastia

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Thank you for the question.

Unfortunately, without direct examination or viewing pictures it is difficult to give you precise advice.  I have found that treatment of congenital symmastia can be challenging. Sometimes patients with “congenital” symmastia  benefit from liposuction surgery of the area between the breasts ( over the sternum);  whether or not you are a candidate for this procedure will depend on your physical examination. 

Yes, you can use a thong bra if you'd like.

You may find in person consultation with well experienced board-certified plastic surgeons to be helpful to you.

Best wishes.

Help for symmastia.

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Thanks for your question.  The thong bra can definitely help to separate your breasts in terms of their appearance.  It won't fix your underlying symmastia but it can make you symmastia appear less noticeable.  There are surgical options available depending on how things look on physical exam.  I would contact a local board certified plastic surgeon for a consultation.

Shaun Parson, MD
Phoenix Plastic Surgeon
4.8 out of 5 stars 47 reviews

Difficult but "doable"

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I have seen a few cases of symmastia,one congenital and four that occurred after breast augmentation done elsewhere.In the case of a congenital symmastia, I had to modify the shape of the breast mound and then suture the skin to the breast bone. In the more common case of symmastia that occurs after breast augmentation, I reinforced the medial aspect of the breast implant pocket with a dermal matrix graft and then reattached the skin to the underlying breastbone. Fortunately the results were satisfactory to excellent in all five cases. This is difficult surgery at times but with the use of dermal matrix grafts, plastic surgeons are achieving better long-term results

Joseph M. Perlman, MD
Houston Plastic Surgeon
4.3 out of 5 stars 27 reviews

Congenital Symmastia Rare

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Congenital symmastia is an extremely rare anomaly which requires an experienced surgeon to really understand not only how it occurred, but what it really takes to correct it.  Often times it requires manipulating the tissues over the sternum, as well as the breast tissue itself to really get the area in the middle of your chest to sit down and provide you with an normal breast and chest appearance.  Sometimes you ned to reinforce areas with some synthetic or biologic material as well to help strengthen everything.  I would go for a consultation with a plastic surgeon who has experience and see what they have to say.  I hope this helps.


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If you have developed symmastia after breast augmentation, there is a relatively new product available, called "Strattice", which is extremely helpful in the surgical treatment of this condition.  It is a pig dermal matrix made by "Lifecell Corporation", that is placed on each side to separate the breasts.  It allows your own tissue to grow in that area to hold the implants in their new position.  It is not a simple operation, nor is it inexpensive, but it works very well.  With any procedure, especially after a complication, it is important to know that you may need further revisions. 

If you are born with symmastia, perhaps "Strattice" may work for you, as well.  If your breasts are together because they are too large, you may just need a reduction mammaplasty.  This procedure would separate your breasts and make you more comfortable.


Diane L. Gerber, MD (retired)
Chicago Plastic Surgeon

Born with Symmastia

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Without photos it is difficult to know that to suggest, other than to go to a board-certified plastic surgeon to see what your options may be, whether using implants or not.

Synmastia: congenita versus acquired

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Photos would be very helpful as what you describe is pretty rare.  Undoubtedly the photos of synmastia you have seen are those in women with implants.  In their cases the pockets made for the implants are too close or may even join into one.  Their actual breasts are still separate and can be made so again with internal repairs.  You have something different.  The only cases of congenital synmastia I have seen are those in which the breast bone is extremely sunken in and is called pectus excavatum.  In these cases the treatment has to be individualized. 

Lori H. Saltz, MD
San Diego Plastic Surgeon
4.3 out of 5 stars 29 reviews

Unusual problem. Need experienced surgeon.

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Synmastia is more commonly caused by breast augmentation.  Your case is unusual.  But the treatment principle is the same.  A thong bra?  Not sure what that is, but I don't think it will suffice.  Do you want implants or is your size okay?  I typically repair synmastia by closing off the capsule medially, preventing the implants from abutting in the midline.  In your case, internal sutures may correct the problem.  But you need an experienced plastic surgeon who has treated this problem before.  And you need to see before and after photos.  Synmastia is not an easy problem to correct.

Eric Swanson, MD
Kansas City Plastic Surgeon
4.7 out of 5 stars 61 reviews

Correction of congenital symmastia

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Congenital symmastia is rare - symmastia is most commonly seen as a complication of breast augmentation.  It can potentially be corrected, however treatment needs to be individualized to the patient.  I would recommend that you consult with a board-certified plastic surgeon.

Good luck.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board-certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Craig S. Rock, MD
Houston Plastic Surgeon
5.0 out of 5 stars 29 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.