Symmastia (sometimes called a “uniboob”) is the name for a condition in which the two breasts join in the middle of the chest to form one shape. Normally, the skin in the center of the chest is stuck down to the sternum, or the breast bone. When this skin separates off the bone and allows communication between the two breast sides, it is called symmastia.
Symmastia can occur either because of the way that the breasts develop (this is very rare), or because of surgery that creates this separation. The most common way that symmastia occurs is after breast augmentation with an implant. If the implant is placed too close to the midline, or if the pocket for the implant is opened too much in the center of the chest, you can result with a symmastia.
Symmastia After Breast Augmentation:
When it comes to breast augmentation, symmastia can also occur during the immediate postoperative period, if the implant moves toward the midline and opens the pocket more itself. Usually, this requires the pocket to already be very open, because it is unusual for an implant to dissect this tissue a very large amount. The resulting separation can be mild, moderate, or severe. In many cases, symmastia can be subtle. It may not show much in a photograph, but in person and by feel, the separation may become apparent.
The treatment of symmastia is often complex and requires extensive experience with breast surgery. In some cases, specialized bras can hold the midline skin down and encourage it to stick back. But in most cases, surgery is required to reposition the implant, reshape the pocket, and attach the tissue back to the bone. Because it is difficult to grab bone with suture, this can be a very challenging task. In cases where the implant is below the muscle, attachments may need to be created on top of rib, which is also a very difficult thing to accomplish.
Symmastia repair is not always successful, and sometimes requires staged procedures. If you think that you have a symmastia, you should consult with a Board Certified plastic surgeon who has experience in diagnosing and treating the condition, and can offer you a structured plan for revision. We welcome you to contact us for an evaluation.