How Symmastia Correction Procedures Work

If you have had breast implants but the implants were misplaced, the malposition may be causing the ‘uniboob’ effect where there is no space between the two breasts. According to Dr. Tom Pousti, a board certified plastic surgeon at Pousti Plastic Surgery, this often occurs when there is not enough natural tissue support along the chest wall, or the surgeon has been too aggressive in creating cleavage for the patient.

Another reason malposition occurs is because the pectoralis muscle is cut during surgery, enabling the implant to move toward the middle of the chest. The scientific term for this effect is called symmastia, and a corrective procedure is required in order to restore the implants and breasts to their appropriate shape and size.

What is Symmastia?

Ideally, the chest wall will have enough muscle to support the increased breast tissue and creates a natural slope when the patient is lying flat on her back. If there is not enough muscle between the breasts, the natural breasts will simply fall to the side.
Symmastia typically occurs in thin women who have very little existing breast tissue or fat around their breast bone. When large implants are used on these patients, the implant can slowly shift across the breast bone, thereby creating the ‘uniboob’. Some surgeons release soft tissues or muscles along the border of the sternum in order to increase cleavage, but this can be extremely difficult to correct and often results in symmastia.
In some cases, a constricting capsule forms around excessively large implants, which creates a ‘rippling’ effect and the makes the breasts appear very unnatural. In this situation, the breasts can be restored with a symmastia correction procedure.

How is Symmastia Correction Procedure Performed?

Symmastia can cause a number of problems in the overall shape of the breasts and often results in the shifting of the nipple-areola complex. Every patient is different, so the symmastia correction procedure may require complete removal of the implants before adding suture reinforcements that will better support the replacement, removal of the extra breast implant capsule, and opening of the breast pocket to allow for better positioning of the implant. In some cases, replacing the original implant with a smaller size can help improve results.
The symmastia correction procedure typically takes between two and three hours, depending on how much work is involved. According to Dr. Pousti, the basic process of the symmastia correction procedure is as follows:
  1. An incision is made (usually under the areola) to expose the underlying tissue, muscle and implant
  2. The tissue that surrounds the implant is removed in the area of the planned repair
  3. The tissue is sutured together to hold the implant in place (using permanent sutures)
  4. The incision is then sutured close
After the procedure, compression garments and a pressure bra can help to improve healing and ensure better symmetry of the breasts. Most patients need to get plenty of bed rest after surgery, drink lots of fluid, and take pain medication. It can take up to a week to recover from the procedure, and the specially-fitted bra will need to worn for approximately one month after the procedure.
Learn more about breast revision surgery in our information guide.