What is Symmastia? Causes, Symptoms & Treatment

What is symmastia?  

Symmastia occurs when the two breasts join together in the middle of the chest, a condition that’s sometimes, and perhaps unkindly, referred to as ‘uni-boob’. Congenital symmastia occurs from birth, is very rare and affects less than 200,000 women. 

Acquired or iatrogenic symmastia is a little more common. It results from a complication following breast reconstruction or augmentation surgery and can occur immediately after the surgery or develop slowly over weeks, months or even years. 

The symptoms of symmastia are purely cosmetic for most women, although it can cause pain and discomfort for some. It typically leads to low confidence and makes women self-conscious about the way their breasts look, which affects their overall wellbeing. It can also make buying flattering clothes more difficult. 

What causes symmastia?

There have been relatively few studies into congenital symmastia, and there’s still some confusion about the cause. However, it is known to have a genetic element and is thought to result from an abnormal collagen arrangement that can run in families. 

The causes of acquired symmastia are clearer, with it being a potential risk and/or complication of breast surgery where the tissue between the breasts becomes stretched and lifts off the breastbone. That allows the implants to connect in the middle, creating the appearance of a single breast. There are several reasons why this might happen during and after surgery. 

Placing the implants too close together

The most common cause of acquired symmastia is implants that are too close together. The surgeon misjudges where the inner edge of one of both implant pockets should be. That allows the implants to merge or overlap, causing the breasts to meet in the middle of the chest.

Using implants that are too large

Surgeons advise their patients on the right size breast implants for their frame. If implants are too large, they can loosen the skin and muscle of the central chest, allowing them to connect. They can also be too wide and extend too far into the middle of the chest.  

Placing the implants over the muscle

Placing the breast implants over rather than underneath the pectoral muscle increases the risk of symmastia. By breaking the pectoral muscle fibres, there’s less protection to prevent the implants from merging. 

Poor structural support

A patient could also have a narrow sternum, with less skin and muscle between the breasts to prevent the implants from merging.  Ageing, a lack of exercise and poor nutrition can also weaken the muscles and connective tissues, which could allow the implants to connect over time.

Importance of Compression Garments Post-Surgery

Following aftercare guidance closely and wearing a supportive, well-fitting compression bra post-breast augmentation is essential in preventing complications such as acquired symmastia. At Enhance, we provide comprehensive aftercare for 12 months following your surgery to prevent post-surgery complications and ensure you maintain the positive results of your breast augmentation for as long as possible.

Symptoms and features of symmastia 

If you have symmastia caused by a breast augmentation, you will notice some movement in your breast implants, with one or both moving towards the centre of your chest, running over the breastbone and meeting in the middle. That will change how your chest looks and will usually cause some soreness and discomfort. 

Another possible indication of symmastia is a change in the position of the nipples. As your implants move towards the centre of your chest, your nipples can appear to rotate outwards as the implants are no longer directly underneath them.    

You’re also likely to notice a visible reduction in your cleavage. The amount of clearly defined cleavage those with symmastia have differs from woman to woman. You may even be able to touch the centre of your chest and move the implants apart, but then they’ll quickly come back towards the middle.  

Thankfully, symmastia doesn’t typically cause any health issues other than some discomfort. The most significant impact is usually on a patient’s wellbeing and self-esteem, which is why some people choose to undergo a symmastia treatment. 

Correcting symmastia with breast augmentation 

There are various symmastia treatment options for both types of the condition. If you have congenital symmastia, one technique that can work well is to first use liposuction to remove a small amount of breast tissue. The surgeon will then attach tissue to the breastbone, suturing to reinforce closure of the capsule and prevent the breast implants moving to the centre of the chest.. They then compress the area to help it heal. 

If you have the more common condition of acquired symmastia, that’s something we can treat at the Enhance Medical Group. The type of breast surgery that’s best will depend on your specific circumstances, but it will involve either an implant removal or reaugmentation. 

As the procedure is invasive, it will have to be performed under general anaesthetic. Your surgeon will temporarily remove the breast implants and close the opening between the breast pockets. They will then adjust the shape and size of the implants to deliver a solution that fits your proportions and creates a more defined look. 

Alternatively, it may not be necessary to correct symmastia with surgery. If the condition occurs soon after the initial augmentation, we may be able to correct it with a special compression bra that separates the breasts and pushes the cleavage skin against the breastbone. 

If the skin adheres to the breastbone over time, it can provide a permanent solution. However, you should only use this method if symmastia occurs and it’s advised by your surgeon, as it can negatively affect the results of augmentation and the appearance of implants in other cases.

Breast symmastia correction with Enhance Medical Group 

As a known risk and complication of breast surgery, the best way to treat symmastia is to prevent it from occurring in the first place. You can do that by choosing a reputable surgeon who is a specialist in breast surgery and has the qualifications and experience to prove it. 

At Enhance Medical Group, all our procedures are performed by highly experienced surgeons who are accredited by the GMC and members of the main representative bodies for maintaining standards in the industry, such as BAAPS, BAPRAS or ISAPS. We also guide you on the most appropriate size and type of implant for your body and provide the highest standard of aftercare. 

If you have acquired symmastia and are considering corrective surgery, that is an area where we can help. The symmastia treatment you’ll need and the price will depend on the level of difficulty and the revision surgery required. Please get in touch for a friendly and sensitive initial consultation.