Symmastia: How Can I Separate my Breasts?

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.

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.

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.
 

Typically we see symmastia, or a confluence of the breasts where there should be some separation in the cleavage area, as a result of implants that push together. With implants, correction of the problem involves rebuilding the inner portion of the scar capsule, but it is a completely different situation without implants. There is no standard set of techniques so it may require some creativity, which fortunately is something that plastic surgeons are known for. I am sure there is some help for your condition and would advise that you see at least a few plastic surgeons.

Hello,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

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.

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.

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

RE :"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?"

As you know, symmastia, or the touching of the breast mounds ("Uniboob") is most commonly seen in badly performed Breast Augmentation (from using implants which are too large and or from making the breast implant pockets too large to the point the pockets communicate.  I have never encountered congenital, nonsurgical symmastia but have seen cases where the underlying chest wall is pushed in allowing the breasts to fall together.

There is no reason why you could not wear a thong bra but it will not reverse the process which has caused this appearance. You would probably benefit from seeing a Plastic or Thoracic surgeon to see if you have a sunken chest (pectus excavatum) which MAY give a similar appearance. Such chests CAN be surgically corrected.

Dr. Peter A Aldea

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.