Symmastia is a condition where the breasts have merged making one breast. There is “web-like” tissue that crosses the sternum connecting to breasts medially.This is also referred to as; “breadloafing,” “kissing implants,” and “uniboob.”
There are 2 types of symmastia; one is congenital, and the other is iatrogenic. Congenital symmastia, meaning you were born with it, is very rare. There have not been many cases reported, with limited knowledge on the ideal treatment. To date, the 2 most common procedures for congenital symmastia are; reduction mammoplasty and liposuction.
More common but still fairly rare is iatrogenic symmastia. This rare complication follows breast augmentation surgery which may present right after surgery or develop later. Symmastia can be minimal where the implants look too close together, to the extreme where the implant pockets merge.
The cause for symmastia can be a surgical error or sometimes occurs when the surgeon is attempting to increase cleavage. Thin women are more prone to getting symmastia due to insufficient breast tissue over the breastbone. Patient with “pectus excavatum,” which is a concave chest, also have a higher risk of symmastia as their implants tend to lean toward the center of their chest.
Breast revision for symmastia can be complicated. Repair for some patients is for the surgeon to reattach fat and skin to the sternum, closing the pockets that have become too wide. More recently, some plastic surgeons use a technique known as “neosubpectoral pockets.” For this procedure, the surgeon creates new pockets under the muscle. Strattice (acellular dermal matrix) may be used on select patients for additional support if the patient’s tissues are thin. If the symmastia is sub-glandular or on top of the muscle the easy correction would be to place it sub-muscular.
Corrective procedures will vary depending on whether the implants were placed over or under the muscle. Fortunately, this complication is rare, but it is essential to choose the correct size and placement for the implants.
Dr. Miguel Delgado, M.D. warns that selecting implants that are too large for your chest size increases the possibility of symmastia.
Breast revision specialist, Dr. Delgado is available for consultation by calling (415) 898-4161.