What is Symmastia?

Breast Symmastia is characterised by the breasts being too close together, causing them to connect in the middle of the chest. This results in a lack of separation and definition.

There are two types of Symmastia:

• Congenital Symmastia: Also known as genetic Symmastia, this occurs when the breasts naturally grow over the breastbone, reducing the appearance of natural cleavage
• Iatrogenic Symmastia: Also known as acquired Symmastia, this is a complication which can arise from surgical procedures involving breast implants, such as Breast Augmentation or Breast Reconstruction

Sometimes known colloquially as a monoboob or a uniboob, Symmastia can impact an individual’s confidence. Symmastia can make it challenging to find flattering and well-fitting clothing and underwear, as the contours of the breasts are distorted. Additionally, poorly fitting sports bras can cause the breast tissue to rub, leading to discomfort.

Symmastia is not a medical concern and is harmless. However, individuals may choose to address this issue. Depending on the cause and severity of the Symmastia, there are several treatments and solutions which can enhance the appearance of the breasts, create definition and restore the appearance of the cleavage.

How Common is Symmastia?

Although exact figures are uncertain, it is generally agreed that Congenital Symmastia is very rare. As it is caused by genetics, if direct female members of your family are affected by Symmastia, it is more likely that you will have it yourself. It is important to remember that breast shape, size and position are individual, and although having Symmastia is rare, it is natural.

Acquired Symmastia is slightly more common, but still understood to be a rare complication occurring in 1-2% of Breast Augmentation cases. Iatrogenic Symmastia is most often associated with a technical error during surgery, highlighting the importance of prioritising a high-quality specialist breast surgeon to carry out your procedure.

How to Prevent Symmastia

Congenital Symmastia is entirely determined by genetics, making it impossible to prevent its occurrence. However, there are several preventative steps patients should consider to reduce the risk of Iatrogenic Symmastia developing.

Choosing the Right Surgeon

Symmastia after Breast Augmentation is often linked to poorly performed surgeries. The most important preventative measure any patient can take to reduce the risk of Symmastia is to carefully research breast surgeons to ensure you find a highly-qualified and experienced medical professional. Cadogan Clinic has hand-picked a team of expert consultant breast surgeons who are dedicated to providing the highest quality patient care and achieving the best possible results.

Follow your Post-Operative Instructions

Closely adhering to your surgeon’s post-operative instructions is vital to prevent Symmastia after Breast Augmentation. The instructions you are given ensure you recover fully, allowing your breast tissue to heal properly around your new breast implants, preventing movement and other complications. Although all of the instructions are essential, the critical points for preventing Symmastia are:

• Wearing the correct post-operative bra: You will be asked to wear a post-operative bra (similar to a sports bra) for 6-8 weeks following your surgery. This will support your breasts and maintain implant position during your initial healing and recovery phase
• Avoid strenuous exercise and activity: You must avoid any vigorous activity, including exercise, for up to 6 weeks during your recovery. Strenuous exercise, such as weight lifting or running, may slow your body’s healing process and weaken the surgical site, causing the breast implants to move, or the implant pocket to stretch, allowing for movement to occur at a later stage
• Sleeping position: Sleeping on your back for 2-3 weeks helps to secure the position of your breast implants and prevents movement and irritation during your recovery
• Attend all post-operative appointments: All surgical patients at Cadogan Clinic have two post-operative appointments; one is scheduled a week after their surgery with our nurses, and the other is scheduled six weeks after their surgery with their surgeon. Attending these appointments is crucial so our expert team can monitor your recovery and catch any potential concerns early on

Strength Training

Maintaining chest strength in the years following your breast surgery is essential to retain the internal support required to hold your breast implants securely in place. Exercises which build and maintain the chest wall muscles include:

• Push-ups
• Dumbbell bench presses
• Cable crossovers
• Bodyweight dips
• Side planks

Monitoring the strength of your chest muscles is especially important if you have a small rib cage, which may naturally have less supportive muscle and connective tissue, potentially increasing the risk of breast implant Symmastia.

How to Fix Symmastia

Regardless of whether Symmastia is genetic or acquired, several treatment options are available. Finding the most suitable treatment for you will depend on the cause and severity of your Symmastia. The best way to establish the most appropriate solution is to speak with a specialist consultant breast surgeon who can examine your breasts and discuss your concerns and desired outcomes in order to develop a bespoke treatment plan which meets your needs.

Non-Surgical Solutions for Symmastia

Non-surgical treatments for Symmastia are limited, but in the right circumstances, can be highly effective.

Corrective Surgical Bra

In cases where acquired Symmastia develops soon after breast surgery, your surgeon may recommend a specialist surgical bra which compresses the centre of the chest, separating the breasts and holding the overlying skin against the breastbone. This allows the skin to adhere to the breastbone, restoring separation and cleavage. If you are concerned that you have developed Symmastia soon after any breast surgery, it is essential to contact your surgeon as quickly as possible so they can determine whether a Symmastia bra is a suitable solution promptly.

Symmastia bra treatment must be recommended and supervised by your surgeon. Misusing a Symmastia bra may negatively affect the results of your surgery and the appearance of your breast implants.

Surgical Solutions for Symmastia

The nature of both types of Symmastia means that surgical intervention is often the most successful solution. The exact surgical techniques required will depend on the cause and severity of your Symmastia.

Symmastia Correction Surgery

For patients who have Congenital Symmastia and who wish to enhance and define the shape of their breasts, Congenital Symmastia Surgery is often the most effective solution. This comprehensive procedure uses a range of techniques to create a flattering and distinct breast contour:

• Liposuction and excision are used to extract excess breast tissue from the centre of the chest, separating the breasts
• Breast implants are inserted into each breast to further define and enhance the shape, as well as to add volume if the patient wishes
• Sutures are used to secure the overlying tissue to the breastbone, addressing the core concern of the Symmastia

For many patients, Congenital Symmastia Surgery offers an effective, long-term solution. Your surgeon will discuss the risk of recurrence in the years following your surgery, which can happen, especially in more severe cases of Symmastia. It is important to be aware of this risk and how it may impact your results when you are considering the procedure.

Breast Implant Removal and Replacement

For patients who are experiencing acquired Symmastia, and Symmastia bra treatment isn’t suitable or hasn’t been successful, Breast Implant Removal and Replacement is often the most suitable treatment. The exact treatment plan your surgeon recommends will depend on the reason for Symmastia developing:

• Changing the size of your breast implants: If your Symmastia has been caused by oversized breast implants being used in your initial surgery, your surgeon may suggest exchanging your breast implants for a smaller size
• Adjusting your breast implant placement: For patients who have found that over-the-muscle breast implant placement has led to Symmastia, your surgeon may remove the implants and replace them with new implants placed behind the pectoral muscles
• Adjusting the breast implant pocket: In cases where Symmastia has been caused by a misjudgement of the implant pocket position, your surgeon can remove the breast implants and carefully place sutures to resize and reposition the breast implant pocket, allowing for new implants to be inserted

It is not unusual for patients to see a different surgeon from the one who performed their initial surgery for Breast Implant Removal and Replacement. In some cases where breast implant Symmastia is particularly severe, it may be necessary to have your breast implants removed and replaced over two surgeries. This allows the tissue between the breasts to adhere securely, reducing the risk of Symmastia recurring.

If you are considering any form of Symmastia treatment, Cadogan Clinic’s dedicated surgical advisors are on hand to discuss your concerns and match you with a specialist breast consultant. Your bespoke surgical plan will be developed during a one-to-one consultation at our award-winning clinic, based in the heart of beautiful Chelsea in London.

Words From Our Founder