Symmastia is a type of Breast Implant Malposition which occurs when the implants are too close together. When the implants slide across the midline of the chest, the skin over the sternum (breast bone) is lifted. As a result, the breasts lose their separation and appear to fuse across the midline giving rise to the term “uniboob.”
Symmastia and Bottoming Out
Breast Augmentation Revision for Symmastia (Uniboob) Before and After pictures. In the before photo, this patient had breast implant malposition with bottoming out (right > left) and symmastia. In the after photo you can see her breast implants have been raised and separated. (To view uncensored photos, click on the image.)
The History of Symmastia Repair
During my training, Symmastia Repair was one of the most difficult and technically demanding Breast Implant Revision Surgeries. The procedure involved closing off the medial aspect of the breast implant pockets with numerous, meticulously placed internal stitches. The goal was to create a barrier along the inner aspect of the breast implants to keep them separated. Surgical hurdles included:
- The sutures were difficult to place.
- The area that needed to be closed was hard to see.
- The tissues were often fragile and prone to the sutures pulling through them.
- The stitches were often visible as dents in the skin along the inner aspect of the breast implants for months.
- And for all the above reasons, the repairs were prone to recurrence.
Modern Improvements in Symmastia Repair
Over the last decade, the Correction of Symmastia has improved in both safety and predictability. Improvements in breast implants, suture material, techniques and patch technology have all contributed to successful symmastia repair.
Breast Implant Improvements
High profile breast implants, especially when oversized for the chest, are associated with a higher incidence of Uniboob. With the return of Silicone Breast Implants, the number of symmastia cases initially decreased, because when compared to Saline Breast Implants, silicone breast implants of the time were softer and sat flatter on the chest wall. They were also lower profile, so they did not lift the skin as much as the higher profile saline implants. However, as silicone breast implants become firmer and higher profile, the incidence of symmastia may again increase.
Suture Material Improvements
Modern suture material is stronger, longer lasting and less inflammatory than older suture material. This allows for more predictable repairs that are more likely to last.
Symmastia Repair Technique Improvements
The biggest improvement Breast Implant Revision Surgery has been the development of the Pseudoneopocket Technique. It is the single most important advancement in the repair of symmastia, because although It may not be easy to say, it has made a difficult operation much simpler to visualize and the results more secure and predictable.
Instead of trying to sew an often thin and fragile pocket closed, this new technique allows for the formation of a new pocket behind the old capsule. Using the old technique, the implant rested upon, and sometimes forced its way through, the capsule repair. On the other hand, the creation of a new pocket naturally excludes the breast implant from the old pocket and further protects the capsule repair.
Patch Technology Improvements
The availability of patch material to reinforce the Symmastia Repair is the second most important modern improvement. After a good repair is made, the addition of a patch helps strengthen the repair and significantly reduces problems with recurrence. This is especially helpful when the capsule is thin.
Breast Augmentation Revision Consultations
Breast Augmentation Revision poses special problems and is more difficult than the initial Breast Augmentation in most cases. If you are looking into Breast Augmentation Revision, be certain to find an experienced Board Certified Plastic Surgeon in your area. In the San Francisco Bay Area, call (925) 943-6353, to schedule a private consultation appointment.
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