Whats Wrong with my Breast Implant? Is This Symnastia? Bottoming out or Just Dropping One at a Time? (photo)

I just had a breast implant for the first time 4 months ago, 375 CC Silicone gel. The right one definitely bothers me more. It seems larger and it seems lower and often feels very funny at the bottom as though I can feel the implant. It also hurts at the sternum on the right one. It seems to have filled out more towards the sternum more than the left also and is definitely lower than the right. What can i do to correct this? Am I bottoming out? Is this symnastia? Massage the left more?

Doctor Answers 4

Breast Issue

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Synmastia is when you do not have any cleavage usually after a breast augmentation.  It is like two breast connected together by a mini porch of tissue.  Occasionally breasts bottom out or they stretch at the bottom and the nipple raises up higher, therefore, it is not in the middle of the breast which looks unusual, which can happen to either breast at the same time, one at a time, or neither.  To diagnose synmastia you should be examined by a board certified plastic surgeon. 

Gainesville Plastic Surgeon
3.8 out of 5 stars 11 reviews

Asymmetric Breasts Post Augmentation

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Your right breast goes more towards your armpit than your left, and the right nipple is closer to the armpit than to the sternum.  It is obvious to me from your upside down photo that this is the way you appeared pre-operatively.  Asymmetries of this nature need to be discussed pre-operatively in order to manage expectations.  I am sure your plastic surgeon mentioned this, but sometimes patients forget (it's not your fault, there are so many things to remember).

Synmastia means that you have one breast and no cleavage in between.  This deformity is not present on the photograph you presented.  Bottoming out means that the distance from your nipple to the bottom of your breast is elongated, and that the nipples have a significant upward tilt.  This also is not demonstrated in your photograph.  I personally do not think breast massaging does much of anything, but those who believe in it feel it decreases the chance of capsular contracture, and since all contractures move upward, neither of your breasts demonstrate any early contracture, and definitely not the right one.  

It is now time to discuss all this with your plastic surgeon.  It's true your breasts are asymmetric; however, without seeing your pre-operative pictures and doing a face to face physical exam, there is no way any of us can intelligently address your concerns. 





Breast issue

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It is difficult to evaluate the photo adequately being that it is upside down and your arms are lifted.  It does not look like symmastia. For instructions on care, you should check with your surgeon.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

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Breast Augmentation and Breast Implant Malposition Problem?

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Thank you for the question and picture.

It is hard to evaluate your situation precisely given that your arms are elevated to some degree when the photograph is taken. The right breast implant does appear to be lower than the left;  whether you will go on to have significant breast asymmetry only time will tell. Given that you are only 4 months out of your breast augmentation procedure, it would be best to continue to be patient and to continue to follow-up with your plastic surgeon.

In the long-term, if your breasts to demonstrate significant asymmetry related to breast implant  pocket asymmetry,  then revisionary breast surgery using capsulorraphy techniques may be helpful.

Best wishes.

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.