Is there a way to fix my uniboob? (photos)

Question

I got my breast done about 1 year ago the doctor noticed the space in between my breast popped out and said he would "try and fix" and went bigger on me (530ccs) now since the implants are bigger my uniboob is much more noticeable. Is there any way to fix this?

Richard Baxter, MD · Answer

I don't understand the rationale for going with larger implants to fix symmastia, since they will be wider and put more pressure on the skin between the breasts. To correct the problem you will probably need narrower implants.

Dallas Buchanan, MD · Answer

Thank you for your pictures and questions. The answer is yes, this can be fixed surgically. However, the caveat is that the repair is often very complex and has a high recurrence rate. The real answer is to avoid it in the first place. This is likely a result of choosing implants that are too wide/large for your anatomy, over-dissection of the implant pocket, or a combination of both. The surgical approach for correction often is customized to the patient so I suggest you see a local plastic surgeon to discuss your unique case. And this time around I would suggest making absolutely sure your surgeon is board certified specifically by the American Board of Plastic Surgery.Hope this helps!Dallas R. Buchanan, MD, FACSOwner & Board-Certified Plastic SurgeonVIVIFY plastic surgery

Daniel Barrett, MD · Answer

Dear bebe55555,
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

Mathew A. Plant, MD, FRCSC · Answer

Correcting a severe symmastia like yours is a challenging procedure but it is fixable. Without examining you it is difficult to be certain but based on the photos I’d suggest downsizing the implants a little bit and having alloderm used to close off the medial borders of both pockets. The skin in between your breasts will probably also need to be sutured down to your sternum to prevent it from forming a web between the breasts. I would suggest having an in-person consultation by a local breast implant revision expert to be properly assessed. Hope that helps!

Tom J. Pousti, MD · Answer

I am sorry to hear about your concerns after breast surgery.  
 
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.
 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.  Activity restrictions are individualized patient by patient, depending on exactly what was found and done during the procedure.  For example, for most of my symmastia  patients, I ask that they avoid pec major related exercises ( especially exercises that involve abduction of their arms) for at least three months after the procedure is performed.
My best advice: select your plastic surgeon carefully. Make sure that he/she has significant experience achieving the types of outcomes you will be pleased with. Then, communicate your goals carefully. Working together you will come up with a good plan to achieve your goals.   
 Best wishes for an outcome that you will be very pleased with.

Connie Hiers, MD, FACS · Answer

Yes, this can be fixed, but you will probably need to go with smaller implants to decrease the chance of a recurrence. This can happen when the implant is too big/wide for your chest wall.

David Bogue, MD · Answer

The uniboob deformity arises from communication of the implant spaces or violation of the sternal skin. Correction is a difficult procedure and requires a new pocket, repair of the existing communication, and sometimes dermal matrix for reinforcement. This is essentially a reconstruction despite being considered cosmetic by insurance companies. A particularly useful approach is the neo-subpectoral pocket approach we designed at Georgetown many years ago.

Gregory Sexton, MD · Answer

Yes it can be fixed, but it can recur, and is a difficult problem. You can try to close off the pockets, separating the implants which usually works, but can recur. The other option would be making a new pocket in front of the muscle if your current implants are under the muscle.Good luck,Greg Sexton, M.D.Columbia, S.C.

Francis (Frank) William Rieger, MD (retired) · Answer

The answer to give is that most times using the correct techniques this can be fixed.  The repair is very complex, but usually can be done with one surgical procedure.  The technique for fixing this has to be individualized to each patient, and has to be described after a thorough examination in an office.  You must understand that the size of the implants have to be reduced, the width of the implants has to also be reduced, and there oftentimes has to be  some narrowing of the scar tissue envelope that surrounds the implants.  The most important decision that you could make would be to choose a Plastic Surgeon who has definite experience in repairing this.  Ask to see some examples of other patients who had this repaired.Good luck to you.Frank Rieger M.D.  Tampa Plastic Surgeon

Richard P. Rand, MD, FACS (retired) · Answer

Because the skin has lifted off the sternum, it is difficult to fix a unibreast. But the last thing you wanted to do was to go bigger as that was doomed to fail. Only if you use a smaller, narrower diameter implant can you hope for any improvement. Then dealing with the pocket is far too complex to discuss here.

Is there a way to fix my uniboob? (photos)

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