What is symmastia and how to correct it

One of the complications that most frightens patients who intend to undergo surgery breast augmentation it is symmastia, also known as the “unisine effect” or loss of the intermammary fold.

Although it occurs in very rare cases, it is one of the complications linked to breast augmentation with the insertion of prostheses.

Symmastia: what is it?

First of all, it should be clarified that symmastia can be congenital, therefore present from birth, and is frequent in women who have particularly large and developed breasts, with the medial part of the breast very united and attached.
This type of symmastia is the most complicated to correct precisely because it is an anatomical component of the patient's body.

Symmastia, unfortunately, can be a surgical complication.

This complication sometimes arises due to the desire of perhaps less experienced doctors to satisfy the requests of patients, who often think that the most beautiful breast is the one with an extremely small space between the breasts. The surgeon then forces a more severe detachment of the medial part, creating a complication.

Other times the cause of symmastia is the improper positioning of breast implants, with the creation of surgical pockets so close to the midline of the chest that the integrity of the connective tissue above the sternum is compromised.

Furthermore, symmastia can be mild or severe and often severe symmastia involves a complete union of the two breasts and a complete detachment of the skin on the sternal part, leading to functional problems of the breasts as well as aesthetic ones.

How is symmastia correction surgery performed?

Symmastia correction surgery is not an easy operation to perform, in fact it can be very complex because a real reconstruction of the line on the sternal plane between the two breasts must be performed.
In more severe cases, in addition to normal and simple stitches, it is necessary to use meshes such as GalaFlex (made of P4HB and known as poly-4-hydroxybutyrate) or biological meshes, which allow the natural shape of the breast to be recreated to then go and correct the symmastia.

It must be said that symmastia, especially if it is very severe, can run the risk of recurring.
The possibility is quite rare but it can still happen precisely because the complete detachment on the sternal plane is in some cases very difficult to correct, especially in patients who want particularly large breasts.

Since I need to correct symmastia, can I get larger dentures?

One of the questions I am asked most frequently by patients who want to correct symmastia is whether they can insert larger prostheses.

Paradoxically, even if the patient's desire is to increase the volume of the breast and fit larger prostheses, increasing traction on that sternal plane which is now effectively detached makes resolving the symmastia even more difficult.

In fact, with a larger prosthesis the stitches and/or mesh that are inserted to correct this complication would be subjected to greater traction, increasing the risk of a subsequent recurrence.

In extremely large and voluminous breasts, in order to correct symmastia, the reconstruction of the midline of the sternal plane is often necessary to reduce the volume of the breast and combine a mastopexy.

Is the scar from the symmastia correction surgery very large?

Usually, in the correction of symmastia, the scar from the previous breast augmentation surgery is used.

Clearly, in the case of reduction in the volume of particularly large breasts, the scar will be different because the correction will be combined with a mastopexy.

How long does the surgery last?

The duration of the operation varies based on the patient's initial conditions and the complexity of the symmastia.
If it is necessary to insert nets, it can last over two hours.
The operation takes place under general anesthesia with an overnight stay in the clinic.

Conclusions on symmastia

Before undergoing breast augmentation, it is essential to rely on a competent and trained plastic, reconstructive and aesthetic surgeon, able to evaluate the feasibility of the operation in light of the patient's requests.

The risk of symmastia is reduced when the patient together with the surgeon choose a breast size and space between the breasts appropriate to the anatomical characteristics of the woman.

For more information on symmastia correction surgery and its costs,
contact me for a consultation in one of my offices in Rome, Milan, Caserta or Den Haag (NL).