Breast Implants Too Close Together - What Has Gone Wrong?

Thank you for the question.

Although it is not clear that you have true symmastia you definitely have medial breast implant malposition.

Symmastia (or medial malposition or “uni-boob”) occurs when the breast implants move too far toward the midline--the two implants may actually touch one another in the center of the chest. If the horizontal muscle that is connected to the sternum and goes across the implant is cut during surgery, then the implant can move toward the middle of the chest.

Symmastia may result from overly aggressive attempts to alter chest wall anatomy trying to increase cleavage for patients. This outcome is made worse by use of larger implants in thin patients, and is a problem for implants over or under the muscle, though sub muscular implant placement allows the muscle to provide some softening of the transition to the cleavage area from the augmented breast mound. Correction involves use of internal sutures of the capsule around the breast implants. Often, it is necessary to expand the breast implant pocket laterally (outwardly) to allow for correct placement of the implants.

Correction of symmastia involves careful planning and intra-operative reinforcement of the medial fold of the breasts. Reconstruction usually involves removal of the breast implants and internal suture reinforcement of the involved area. The use of dyes and needles through the skin surface assists the exact placement of permanent sutures. Usually the breast implant capsule that is redundant is removed to allow for two raw surfaces to heal together, presumably lowering the rate of recurrence of the symmastia.

Often, it is necessary to “open” the breast implant pocket laterally (outer breast fold) to allow for positioning of the implant centrally behind the breast mound. This maneuver may also decrease the amount of implant pressure against the medial suture line. Use of a smaller breast implant, if possible, may serve the same purpose.

Correction of implant malposition issues does require  some experience;  make sure your plastic surgeon can demonstrate his/her experience level.

Best wishes.

Symmastia is a condition which can occur when the implants are too close together. Patients often refer to this as a “uniboob.” Occassionally, the space or pocket for the breast implant is created towards the center, or the tissue stretches, forcing  the implants to fall too much towards the center of the breasts.  Correction of this problem may involve using different implants such as textured, a smaller size, or a smaller base and placing the implants in a new #pocket. On occasion, this may require surgery in more than one stage to allow the tissues to heal and then place the implants. If the implants have been placed above the muscle, converting them under the muscle frequently will help and, again, the use of a dermal substitute may be required for additional support if the tissues are thin. The techniques of #capsulorrhaphy and #neopectoral pockets may apply here as well.  Additional elective cosmetic #surgery is a personal choice. Your procedures should always be performed by a #PlasticSurgeon who is board-certified and has a great deal of experience specializing in cosmetic #surgery. You will then greatly improve your chances of getting the result you desire, and, without the need for a revision surgery. It is suggested that you look at before and after photos of the surgeons actual patients, and read patient reviews. Gathering all of this information will help you make a well-informed decision.

Your breast show problem called a symmastia. Often implants placed too close to the midline can cause elevation of the skin. This is also more common with sub glandular placement rather than  sub muscular.