Synmastia or Symmastia: What Is It? How Does it Happen? How is it Corrected?
What is Symmastia?
Synmastia or Symmastia is a condition in which the breast implants are sitting too close together. This causes the skin above the breast bone to lift. It results in the loss of definition between the breasts. The cleavage that was once there is gone. The implants may even be touching in some cases. It can result in mild pain as well. Sometimes there are visible ripples in the center of the chest. The nipples also often point outward once symmastia begins. The nipples could also appear too far apart.
Symmastia can occur to varying degrees. For example, one breast implant may move toward the center while the other stays in place. Or both could move yet some tissue may remain connected above the sternum. Or the tissue could be completely loose, resulting in the look of one implant instead of two.
Symmastia Photos and Correction*
Synmastia may be known as symmastia; it’s the same condition known by more than one name. This condition is also sometimes called bread-loafing, kissing implants, or even uni-boob. Though the names may sound funny, the condition is not. It is awkward and difficult to correct. Thankfully, it is not a common problem.
A fear of many who have breast augmentation is that the gap between the breasts will appear too wide resulting in a wide gap breast augmentation result. This is of particular concern for patients who do not have a lot of breast tissue in the upper half of the breast. Other patients may be looking to increase the appearance of cleavage. To address this, some plastic surgeons may place the implants as far inward on the chest as possible. They may even loosen the chest muscle and other tissue in the area to allow the implants closer. This is a risky choice and is the cause of symmastia. This is because this action can allow the breast implants too close. They can move further inward and release some of the remaining central tissue. This removes the appearance of cleavage entirely.
Simply stated, the tissue between the breasts should not be changed. This is the best way to reduce the risk of symmastia. If a woman’s natural anatomy gives a wide gap between the breasts, she should know that this will not be changed much with breast augmentation. (And for some, the result will be magnified, not lessened).
That said, symmastia can still occur even when the central tissues have not been cut. And it does not matter whether the implant was above or below the muscle; there is a risk (though low) either way. Here are some risk factors:
- Sometimes the tissue is too weak to hold the implant in place.
- Sometimes the muscle was cut for the standard placement, but that cut may still allow the implant to move.
- The shape of the rib cage may also be a factor; sometimes the rib cage is curved downward.
- Some women may also have a lowered breastbone, which can allow the implants to move inward.
- Breast Implants that are too large for the woman’s chest can also contribute. They push the tissue outward. This is typically the cause.
Regardless of the cause, synmastia can occur within a few days of surgery or it may occur over time.
It is actually quite difficult to correct. Some women may be able to temporarily hold the breast implants in place with a bra, such as a “t-back” sports bra worn backward. This is only a temporary fix. If you are having symptoms of symmastia, get to your plastic surgeon as soon as possible. If it has been present for a long time, this may also result in stretched tissue that must also be repaired. (This tissue may also ripple; this may or may not go away with the repair).
To fix the issue, the plastic surgeon must remove the implants and repair the tissue and put them back in. The tissue is held in place with internal sutures and allowed to heal. It is important to make the repair internally; using only external sutures will scar. It also will not be a long-term fix. Replacing the breast implants can be done but it does make the repair more complex. Switching to smaller implants will not correct the problem without also repairing the tissue.
As this is a difficult procedure, be sure to ask your surgeon how much experience they have with it. Even an experienced plastic surgeon may need more than one surgery to fully repair symmastia.
She had her large breast augmentation done elsewhere and requested correction of the Symmastia but declined a breast revision for nipple positions.*
George Washington University Professional Center
The Loudoun Center for Plastic Surgery
45155 Research Place, Suite 125
Ashburn, VA 20165