Do I have symmastia and should I consider a revision? Over 1 year post op. (photo)

Question

I had a breast aug done over a year ago and the doc told me I could fit 500 hp silicon. I’m just now realizing that the skin connects at the bottom where the sternum is and I do have raised skin there too. I just absolutely hate the thought of having to have a revision and I have so much anxiety over this. My husband never even noticed the issue. I’m just wanting an honest opinion from a doctor if you think this needs to be corrected . Thanks so much

Ronald J. Edelson, MD · Answer

Synmastia is so uncommon after breast implants. I’ve never seen an actual case. I doubt you have synmastia. It’s a nice result and you should enjoy it. You have great cleavage which is not always achievesble

Gianfranco Frojo, MD · Answer

I think that downsizing implants with a smaller volume and smaller base width may be all that is needed. It is difficult to provide optimal recommendations based on the single photo that does not truly show the issue in its entirety. I would see an experienced aesthetic plastic surgeon to get an opinion on this issue.

John Michael Thomassen, MD · Answer

Yes, this is symmastia.  A correction by suturing the capsule medially on both sides should correct this.

Christopher Pannucci, MD, MS · Answer

Hi MIssytexas08,
Based on the photo, you have a sharp cleavage and a visible right to left separation. If you can't push the implants across midline (eg something not seen in the photo), then there's no concern...synmastia is either where you have no clear right to left separation between the breasts, or where the right and left breast pockets connect across the midline. 
Any revision would be driven by whether something bothers you--based on the photo, there is no reason you have to have a revision.
Hope this helps.
Best,Christopher Pannucci MD MSBoard Certified Plastic SurgeonPlastic Surgery NorthwestSpokane, Washington

Gary M. Horndeski, MD · Answer

You can see in your photograph that your implants are in front of the muscle, are bottoming out and you are getting symmastia.  I recommended smaller implants and plication medially.

Best Wishes,

Gary Horndeski, M.D.

Harry T. Haramis, MD, FACS · Answer

You do not appear to have symmastia, which is implants across the midline.

Your natural breast anatomy has them very close cleavage.

A revision has risks and does not appear necessary. You would likely need smaller implants, possibly mesh, costly and not change your midline anatomy enough to warrant.

Close follow up with your plastic surgeon is recommended for reassurance.

Wess Cohen, MD · Answer

Thank you for your question. Send mass is when the breasts have a connection under the skin. It’s difficult to tell, but it appears that your breasts aren’t touching because your cleavage is so large. If you are happy with the outcome, then I revision is not necessary. Good luck

Daniel Barrett, MD · Answer

Dear Missytexas08,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Connie Hiers, MD, FACS · Answer

If you are content with what you have, then leave things alone. If you want something done, you will need to go down in size because these implants are too large for your frame.

Camille Cash, MD · Answer

Symmastia is when the skin is lifted and the implants can be moved from one side to the other.  Your photo doesn't demonstrate this.  If you are not bothered by the appearance it is not medically necessary to correct it. Visit with your surgeon to discuss your concerns.

Do I have symmastia and should I consider a revision? Over 1 year post op. (photo)

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