Symmastia, a Not-So-Ordinary Breast Augmentation Complication

With any type of surgery there are similar risks for certain complications, like infection or bleeding.

With breast implants there are some complications that are 'unique' to breast augmentations. Symmastia is one of these not-so-ordinary breast augmentation complications.

 breast augmentation complication symmastia

Trying my best not to sound like a harbinger of doom here, I just think its so important to be FULLY informed about all things breast implants... the good AND the bad. So let me tell you a bit about symmastia...

What is Symmastia?

Symmastia (also called uniboobbreadloafing, or tenting) is when breast implants are too close together.

Symmastia is a serious (but rare) complication of breast augmentation. It's a 'cosmetic' complication because it affects how the breasts look.

 breast augmentation complication symmastia

When the breast implants end up too close together there is no natural 'gap' between the breasts... and it is definitely an undesirable outcome.

You can see it from the front but it's definitely obvious if looking up at the underneath of breasts (the bottom picture shows breasts with symmastia).

What Causes Symmastia?

It's rare, but some women are born with a chest wall deformity that will make the breasts implants meet in the middle after a breast augmentation (called 'congenital symmastia' - and a good plastic surgeon should be able to spot this).

The most common cause of symmastia though is improper placement of breast implants. It happens when breast implants are too large for your frame and/or the breast pocket is overdissected (cut too wide).

Which means, the main cause of symmastia is surgical error

It's more common with breast implants placed over the muscle, but it can occur with bresat implants placed under the muscle too. It can also happen in one or both breasts.

When a plastic surgeon performs a breast augmentation they create a 'pocket' inside each breast for each breast implant to be placed. If this pocket is not created accurately (and is cut too close to the middle of the chest), and/or the breast implants placed are too big for your body, it can weaken the connective tissue in between your breasts.

Another reason to be sure you find an awesome, experienced, board-certified surgeon!

How Will I Know If I Have Symmastia?

Symmastia can be subtle. But more often than not you'll know if this happens to you. Mainly because you'll be able to see it.

The breasts will look like they join, there may be swelling in between the breasts (after the post-surgical swelling has gone down) and the skin across the sternum (the bone down the middle of your chest, between your breasts) will lift.

 breast augmentation complication symmastia picture

If at any time you are concerned about the look or feel of your breast implants after your breast augmentation, call your plastic surgeon.

Don’t ignore symmastia... it can get worse if not fixed.

If you are worried you may be developing symmastia it needs to be checked out ASAP to prevent any further separation and damage.

Can Symmastia Be Prevented?

Symmastia is a complication that a skilled surgeon knows how to avoid causing. Which is why it is SO important to choose a board-certified surgeon with extensive experience carrying out breast augmentations.

You can reduce the risk of symmastia buy choosing a breast implant that is the right shape, size, and profile for your body (FYI - this selection process is driven by your surgeon's knowledge and skill).

Breast implants that are too wide or too large increase the risk. This doesn't mean you can't go big... but if you do want a supersized look choose a surgeon skilled in larger augmentations.

How Is Symmastia Fixed?

The good news is symmastia can be corrected. The bad news is that it's a complicated revision surgery.

 How Is Symmastia Fixed?

The repair is difficult, but it's not impossible!

There's a few ways to approach symmastia repair depending where your breast implants are placed and how much damage there is:

  • If your breast implants are over the muscle (subglandular) the repair will involve removing the breast implants and placing them under the muscle (submuscular).

  • Internal stitches are also often needed in the capsule that surrounds the implants to keep them in place.

  • If your breast implants are already submuscular, the muscles may need to be stitched near the sternum and under the breasts.

  • In some cases, a special material (called Alloderm or Strattice Regenerative Tissue Matrix) can be used to create a barrier between the breast implants, stopping them from moving together again.

  • If your breast implants are too big or wide you'll have to downsize.

  • And sometimes... it may require surgery in more than one stage to allow your tissues to heal and then place new breast implants.

If you do find yourself at the rough end of this complication it’s probably not a good idea to have your original plastic surgeon try to fix symmastia.

You will need a plastic surgeon who is experienced at carrying out complex breast revision surgery. You really don’t want an unskilled repair causing more problems.

It's so important when you're traveling this boobie journey that you know all of the "ins" as well as the "outs". While complications are rare, they do happen.

If you find yourself in the unfortunate position of suffering complications it can be a big advantage knowing some of the surgical terminology. Being informed can aid you in finding a plastic surgeon who uses the latest and most successful surgical techniques for revision.

And most importantly, being informed and choosing the right plastic surgeon will give you a long and happy relationship with your breasts :)

Thoughts from Dr. Ben Wood

Symmastia can be a challenging issue if it occurs. For that reason, we take great care to precisely create the space when placing the implant.

There are ways to correct it though, and like many things in surgery, the technology around new products such as a dissolving mesh called Galatea have advanced the ability to revise symmastia.