About Symmastia, Synmastia, or “Uniboob”

There are millions of women in the U.S who have undergone breast augmentation. This commonly performed procedure has given the overwhelming majority of these women great happiness and satisfaction. It is an operation normally performed safely as an outpatient with minimal risk of complications.

A small number of the women who have breast augmentation can develop a malposition of the breast implant(s) called symmastia or synmastia and is sometimes known as “uniboob.”

Symmastia occurs when the breast implant pockets extend too far centrally over or across the breast bone. Sometimes both breast implant pockets may even join together in the middle creating one large pocket. This allows the implant to shift over the breast bone (sternum) creating a fullness in the middle and a distortion of the breast shape. The breasts may appear to be joined in the middle with loss of cleavage.

Symmastia is an uncommon occurrence after breast augmentation. It may be caused by choosing implants that are too large for the amount of skin that is available. This leads to excessive tension on the tissues over the breast bone from a large implant pulling the skin forward and off of the chest wall. It may be sometimes be caused by excessive pocket dissection centrally at the time of surgery. Fortunately, it is a condition that can be corrected.

Breast revision surgery can be performed to reposition the breast implant pocket so that the implant is centered behind the breast and the nipple. At the same time, the portion of the breast implant pocket that extends too far centrally is closed off to prevent the implant from shifting in this direction. Closing off this portion of the pocket also returns the skin and tissues back down to the chest and breast bone, re-establishing both cleavage and an appropriate space between the breasts.

In the past, many surgeons have recommended that the implants be removed during the recovery and healing process after correcting the symmastia. This was to prevent the weight and movement of the implant(s) from destroying the synmastia repair before it had a chance to heal properly. After satisfactory healing had taken place, breast implants could then be replaced. Unfortunately, this was a two-step process which required purchase of additional implants.

Dr. Nein has had great success in treating cases of symmastia with a one stage procedure. This repair does not require (in the vast majority of cases) a second procedure and does not require removal of the implants for a period of time. Using a biological mesh material (SERI) to reinforce the breast revision adds strength and stability. The SERI is placed internally over the repair. The SERI is eventually reabsorbed by the body but leaves behind a strong layer of tissue to hold the implants in place. This additional strength allows Dr. Nein to perform the entire operation in one step, saving expense and recovery time. For additional questions about synmastia repair please contact our office at 615-327-0201.

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