Symmastia is a rare and often distressing condition that impacts the natural separation of the breasts. Whether congenital or acquired, it can significantly alter the chest’s appearance and may cause emotional distress. We will discuss what symmastia is, the differences between congenital and acquired forms, potential causes, and various treatment options available to restore the appearance of natural cleavage.

What is Symmastia?

Symmastia is a condition where the breasts appear to be connected across the midline of the chest, often referred to as a “uniboob.” This occurs when there is no visible separation between the breasts. Symmastia can be congenital, meaning it is present from birth, or it can develop after breast augmentation surgery.

The term “uniboob” is commonly used to describe this condition, and while it may sound humorous, it can be a source of significant emotional distress for individuals affected. The merged appearance of the breasts disrupts the natural contour of the chest and can affect one’s self-confidence.

Key Symptoms of Symmastia

• Loss of cleavage line between the breasts

• A visible or palpable connection of breast tissue or implants across the sternum

• Skin elevation between the breasts, particularly after breast augmentation

Understanding the underlying cause of symmastia is crucial for determining the appropriate treatment.

Congenital Symmastia vs. Acquired Symmastia: What’s the Difference?

Congenital Symmastia

Congenital symmastia is a condition that is present from birth. It results from the improper development of chest tissues and muscles. This type of symmastia becomes more noticeable during puberty, when breast tissue begins to develop, accentuating the lack of a clear cleavage line.

Characteristics of Congenital Symmastia

• The breast tissue appears fused across the chest even before any surgical intervention.

• The abnormal development of the pectoral fascia and chest muscles leads to the fusion of the skin and underlying tissue.

• In some cases, congenital symmastia can be associated with genetic factors or developmental anomalies.

Acquired Symmastia

Acquired symmastia occurs as a complication of breast augmentation surgery. It often results from over-dissection of the tissue along the sternum, implant placement that is too close together, or excessive implant size for the patient’s chest anatomy. This form of symmastia may not be immediately noticeable after surgery but can develop as the body heals and swelling decreases.

Characteristics of Acquired Symmastia

• Loss of the natural cleavage following breast augmentation

• Implants may drift toward the midline over time

• Skin elevation over the sternum due to tissue tension or implant movement

Why Understanding the Type of Symmastia is Important

Knowing whether symmastia is congenital or acquired helps determine the best treatment plan. Each type requires a tailored surgical approach to restore a natural and aesthetically pleasing chest contour.

Causes of Symmastia

What Causes Congenital Symmastia?

The exact cause of congenital symmastia is not entirely understood. However, it is thought to be related to genetic factors or developmental abnormalities that affect how the chest muscles and breast tissues form. During fetal development, the chest wall and skin may not separate properly, leading to a fused appearance.

According to research published in the Journal of Plastic, Reconstructive & Aesthetic Surgery, congenital symmastia is often related to an abnormal connection between the skin and underlying tissues, including the pectoral muscles and fascia. This abnormality can become more pronounced as breast tissue develops during puberty.

What Causes Acquired Symmastia?

Acquired symmastia is most commonly associated with complications from breast augmentation surgery. Several factors can contribute to its development:

1. Over-Dissection of the Breast Pocket: When a surgeon dissects too much tissue near the sternum to create a pocket for the implant, it can weaken the natural structures that separate the breasts. This can lead to implant migration toward the midline, creating a joined appearance.

2. Implant Size and Placement: Using implants that are too large for the patient’s chest width or placing implants too close to the centre of the chest can increase the risk of developing symmastia. The excessive pressure on the skin and soft tissues can cause the implants to shift.

3. Chest Anatomy and Skin Elasticity: Patients with thin or weak tissue between the breasts or a narrow chest wall are more prone to developing symmastia after breast augmentation. Additionally, skin that is naturally more elastic may be less capable of holding the implants in place.

4. Postoperative Factors: Activities that put stress on the chest muscles, trauma to the chest area, or poor postoperative care can also increase the risk of implant migration and symmastia.

A study in Plastic and Reconstructive Surgery journal emphasises that understanding patient anatomy and using appropriate surgical techniques are critical for preventing acquired symmastia.

Why Are My Breasts Joined Together After Breast Augmentation?

If you notice that your breasts seem joined or merged after breast augmentation, it could be a sign of acquired symmastia. This condition may develop gradually as your body heals, and it is more likely to occur if the implants were placed too close to the midline or if the dissection of the breast pocket was too extensive.

Patients often describe their chest as having a “stretched” or “tight” feeling, especially in the midline area. The skin between the breasts may also feel elevated or taut, particularly when the implants are under muscle tension.

What is a Uniboob?

The term “uniboob” is a slang expression used to describe the appearance of merged breasts due to symmastia. The breasts seem to form a single, continuous mass with no visible cleavage line. While the term may sound lighthearted, the condition can be quite distressing for those affected.

The uniboob appearance not only affects the aesthetics of the chest but may also impact clothing choices and self-confidence. Fortunately, various surgical techniques can be used to correct this issue and restore a more natural breast contour.

How to Treat Congenital Symmastia

Treating congenital symmastia requires a careful and strategic surgical approach. The goal is to separate the fused tissues and create a natural-looking cleavage. Here’s how it can be done:

1. Surgical Tissue Release: The surgeon will carefully release the skin and tissues that are fused across the chest. This step involves precise dissection to avoid damage to the underlying structures while achieving the desired separation.

2. Internal Suturing Techniques: Once the tissues are released, the surgeon may use plication sutures to anchor the skin and soft tissues in place. These sutures help maintain the separation of the breasts and create a stable cleavage.

3. Fat Grafting: In some cases, autologous fat grafting may be used to enhance the appearance of the cleavage area. The surgeon will harvest fat from another part of your body, such as the abdomen or thighs, and inject it into the cleavage area to add volume and improve contour.

4. Skin Tightening: If the skin between the breasts is loose or sagging, skin-tightening procedures may be necessary to achieve a more refined result. This can involve excising excess skin or using non-surgical skin-tightening technologies.

Surgical Outcomes and Considerations

A case study published in the Aesthetic Surgery Journal highlighted a successful congenital symmastia correction using tissue release and internal suturing techniques. The patients experienced significant improvement in chest aesthetics and reported high satisfaction rates.

Treating Symmastia After Breast Augmentation

Correcting acquired symmastia is a more complex procedure that may involve several surgical techniques:

Capsulorrhaphy

Capsulorrhaphy is a surgical procedure that involves tightening or repairing the capsule surrounding the breast implant. The surgeon will use internal sutures to create a stronger, more secure pocket for the implant, preventing it from shifting toward the midline.

• Internal Suturing: The sutures are placed strategically to hold the implant in the correct position and recreate a natural cleavage line.

• Pocket Reinforcement: In some cases, additional support may be needed to stabilise the implant. This can be achieved using mesh or acellular dermal matrix (ADM) products.

Pocket Modification

Adjusting the implant pocket is crucial to ensure the implants remain in the desired position. This may involve creating a new pocket or modifying the existing one to provide better support.

• Creating a New Pocket: We may create a new pocket that is properly aligned with the chest anatomy, reducing the risk of recurrence.

• Using ADM Products: Acellular dermal matrix materials like Strattice or AlloDerm provide structural support to the weakened tissue, helping to stabilise the implant and prevent future migration.

Implant Exchange

If the implants used in the initial surgery are too large for the patient’s chest anatomy, downsizing may be necessary. Smaller implants reduce the tension on the tissues and can improve the overall aesthetic result.

Fat Grafting

Fat grafting can be used as a complementary procedure to improve the overall aesthetic outcome of symmastia correction. During this process, fat is harvested from areas like the abdomen or thighs using liposuction. The harvested fat is then purified and carefully injected into the cleavage area. This adds volume, enhances the natural contour, and provides additional support to the skin and underlying tissues.

Fat grafting can also be used to smooth out any irregularities and improve the feel of the breasts, giving a more natural look and texture. According to a study published in Plastic and Reconstructive Surgery, fat grafting has shown promising results in enhancing breast aesthetics, especially in complex cases like symmastia correction.

The postop result of symmastia correction with internal suture technique and pocket adjustment.

Postoperative Care and Recovery After Symmastia Correction

Whether you’re undergoing treatment for congenital or acquired symmastia, proper postoperative care is essential for achieving the best possible outcome. Recovery protocols may vary depending on the complexity of the surgery, but here are some general guidelines:

Immediate Postoperative Care

1. Wearing a Compression Bra: We recommend wearing a specialised compression bra to provide support and reduce swelling. This garment helps keep the breasts in the correct position and promotes healing.

2. Avoiding Physical Strain: It’s crucial to avoid activities that involve heavy lifting, strenuous exercise, or any movement that could strain the chest muscles. Follow your surgeon’s advice on when it’s safe to resume these activities.

3. Managing Pain and Swelling: Pain and swelling are common after surgery, but they can be managed with prescribed pain medication and anti-inflammatory drugs. Keeping your upper body elevated while resting can also help minimise swelling.

Long-Term Recovery

1. Monitoring Healing Progress: Regular follow-up appointments with us are important to monitor the healing process and ensure that the breasts are settling into their correct positions. We will check for signs of complications, such as implant displacement or asymmetry.

2. Scar Management: If incisions were made, scar management techniques such as silicone gel sheets or scar massage may be recommended to minimise the appearance of scars. Over time, the scars will typically fade and become less noticeable.

Expected Results

The results of symmastia correction can be highly satisfying when performed by an experienced plastic surgeon. Patients often report an improvement in chest aesthetics and a significant boost in self-confidence. It’s essential to have realistic expectations and understand that while the surgery can greatly improve the appearance of the cleavage, it may not be possible to achieve perfect symmetry.

Can Symmastia Recur After Treatment?

While symmastia correction surgery has a high success rate, there is always a risk of recurrence, particularly if the underlying factors, such as implant size and chest anatomy, are not adequately addressed. Following your surgeon’s postoperative care instructions and avoiding activities that may put strain on your chest can reduce the risk of recurrence.

Choosing the Right Plastic Surgeon for Symmastia Correction

Correcting symmastia is a complex procedure that requires a high level of surgical skill and experience. When selecting a plastic surgeon, consider the following:

1. Cosmetic Certification: Ensure that your surgeon is cosmetic surgery certified by the Royal College of Surgeons and specialises in breast surgery and complex breast augmentation revisions.

2. Experience with Symmastia Cases: Ask to see before-and-after photos of patients who have undergone symmastia correction. This will give you a better idea of the surgeon’s expertise and the quality of their work.

3. Patient Reviews: Reading patient testimonials and reviews can provide valuable insight into the surgeon’s approach to patient care and the satisfaction of their previous patients.

“I had a breast surgery with Dr Nassab in April this year. It was my 4th breast surgery as I had a symmastia and tried to fix it but every surgery was a disappointment. It was the best decision ever to choose Dr Nassab, he is truly the best and gave me the boobs of my dreams 🙏 Forever thankful.” Patient review following symmastia correction.

At our clinic, we take a personalised approach to each case, understanding that every patient’s anatomy and aesthetic goals are unique. We use advanced surgical techniques and evidence-based practices to deliver optimal results.

Frequently Asked Questions About Symmastia

1. Can Symmastia Be Prevented During Breast Augmentation?

Preventing acquired symmastia involves careful preoperative planning and surgical precision. Choosing the right implant size, avoiding over-dissection of the breast pocket, and using appropriate implant placement techniques are crucial steps in prevention. Patients with a narrow chest wall or thin tissues may require special considerations, such as smaller implants or additional reinforcement materials.

2. How Do I Know if I Have Acquired Symmastia?

If you notice that your breasts are merging together or feel an unusual tightness in the midline of your chest after breast augmentation, you may have developed symmastia. This may sometimes happen early due to swelling.

3. Is Symmastia Correction Painful?

Symmastia correction surgery involves some level of discomfort, but pain can be managed effectively with medication. Most patients report that the discomfort is manageable and improves within the first week of recovery. We will provide guidance on pain management and what to expect during the healing process.

4. How Much Does Symmastia Correction Surgery Cost?

The cost of symmastia correction surgery varies based on the complexity of the case, the techniques used, and the procedure. After a detailed consultation withMr Nassab, we will give you a clearer understanding of the cost involved. It’s important to prioritise skill and experience over price to achieve the best outcome.

5. Can I Have Symmastia Correction and a Breast Lift at the Same Time?

In some cases, symmastia correction can be combined with other breast procedures, such as a breast lift or implant exchange. This approach can improve the overall appearance of the breasts and address multiple concerns in one surgery. We will assess your anatomy and aesthetic goals to determine the best surgical plan for you.

Final Thoughts

Symmastia, whether congenital or acquired, can be effectively treated with the right surgical approach. If you’re experiencing distress or dissatisfaction with the appearance of your cleavage, book a consultation with Mr Nassab plastic surgeon in Manchester, Cheshire and Dubai. This is the first step toward achieving a more natural and aesthetically pleasing result. Remember that each case is unique, and a tailored treatment plan is essential for optimal outcomes.