Do you know what symmastia is? Discover how it can arise and be treated

• July 29, 2025
• By Fernando Amato

Acquired symmastia is a condition little known to the general public, but it can cause aesthetic and emotional discomfort. It is characterized by the abnormal union between the breasts, usually after plastic surgery, such as the placement of breast implants. The good news is that with proper diagnosis and professional guidance, treatment is available.

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Article highlights

💡 Acquired symmastia usually occurs after breast implant placement.

🔍 Symptoms include breast union and absence of the intermammary sulcus.

⚠️ It can be associated with surgical complications or inadequate techniques.

👨‍⚕️ Treatment may involve surgical correction and implant repositioning.

🛑 Choosing an experienced surgeon is essential to avoid complications.

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🔎 What is acquired symmastia?

Symmastia is defined by the fusion or abnormal union between the breasts, with the disappearance of the medial mammary sulcus (the natural depression between the breasts). When this condition occurs without being present from birth, we call it acquired symmastia.

It can occur as a complication after breast surgeries, especially in augmentation procedures with silicone implants.

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🧪 Causes of acquired symmastia

Acquired symmastia occurs, for the most part, due to surgical reasons. The most common causes are:

• Excessive dissection during implant placement, creating a communication between the two breast pockets.
• Use of implants of inadequate size or shape for the patient's body.
• Incorrect choice of implant position (subglandular or submuscular).
• Flawed surgical technique, with violation of the central chest area.
• Factors related to individual healing, which can lead to seroma formation (fluid accumulation) and implant displacement.

Furthermore, there are increased risks in patients with very thin skin, significant sagging, or reduced breast tissue.

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🧭 How to identify the signs of symmastia?

The signs of acquired symmastia usually appear in the weeks or months following plastic surgery. The main symptoms include:

• Loss of the sulcus between the breasts, making them appear “united.”
• Sensation of implants being centralized or touching each other.
• Aesthetic discomfort with the appearance of a “uniboob” or single breast.
• Medial displacement of implants with changes in breast shape.
• Eventually, pain or discomfort in the center of the chest.

In some cases, there may also be the presence of seroma or internal cicatricial changes.

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📉 Risks and impacts of acquired symmastia

Although it does not pose a direct health risk, acquired symmastia can have significant impacts on the patient's self-esteem and quality of life. Aesthetic discomfort leads many women to avoid low-cut clothing, feel embarrassed in intimate or public settings, and even develop anxiety or depression.

Furthermore, there may be a need for reoperations, which involves new costs, exposure to anesthesia, and a new recovery period.

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🏥 How is acquired symmastia diagnosed?

Diagnosis is clinical, made through a detailed physical evaluation by the plastic surgeon. In some cases, imaging exams such as ultrasound or magnetic resonance imaging can help to:

• Identify implant displacement;
• Evaluate the presence of seromas;
• Visualize the internal anatomy and the degree of separation between the breasts.

It is essential to seek a specialist experienced in breast surgery for a correct evaluation.

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🛠️ What are the available treatments for acquired symmastia?

Correction of acquired symmastia usually requires new plastic surgery. Treatment options include:

1. Surgical correction of the intermammary sulcus

The surgeon repositions the tissues and reconstructs the central area to reestablish the natural separation between the breasts.

2. Implant exchange or repositioning

It may be necessary to exchange the implant for a smaller size or change its position (from subglandular to submuscular, for example).

3. Use of flaps or grafts

In complex cases, tissue flaps or fat grafts may be used to reinforce the medial wall between the breasts.

4. Suspension with mastopexy techniques

When associated with sagging, breast lift can be combined with symmastia correction.

Treatment should be individualized, taking into account the patient's anatomical characteristics, the type of implant, and techniques previously used.

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🛡️ Is it possible to prevent acquired symmastia?

Yes, and prevention is the best approach. Some strategies include:

• Choosing an experienced plastic surgeon and member of the SBCP.
• Performing a careful preoperative evaluation, with simulation of the ideal volume.
• Avoiding implants that are too large for the patient's body type.
• Correctly following the preoperative instructions and medical guidelines.
• Avoiding physical exertion and movements that could displace the implants postoperatively.
• Quitting smoking before surgery, as smoking negatively interferes with healing.

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📅 When to seek medical help?

If you have undergone breast surgery and notice:

• Changes in breast shape;
• Sensation of union or change in the sulcus between the breasts;
• Persistent pain or aesthetic deformities;

Seek a specialized plastic surgeon, such as Dr. Fernando Amato, for evaluation and guidance on the most appropriate treatment.

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👨‍⚕️ Conclusion: taking care of aesthetics is also taking care of emotional health

Acquired symmastia after plastic surgery is a condition that can be successfully treated. However, its prevention begins with the conscious choice of a qualified professional, attention to medical guidelines, and appropriate follow-up.

If you suspect you may have symmastia or have questions about your breast surgery, schedule a consultation with Dr. Fernando Amato, a specialist in plastic surgery, and have the peace of mind of safe and ethical care.

👉 Click here to schedule your consultation

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Questions and Answers:

1. What is acquired symmastia? It is the abnormal union between the breasts that occurs after plastic surgery, usually due to technical failures or complications.
2. Is symmastia common after silicone implants? It is not common, but it can occur if the implant is poorly positioned or if there is a technical error during surgery.
3. How do I know if I have symmastia? The main sign is the loss of the natural space between the breasts. The implants appear “glued” to the center of the chest.
4. Is there a treatment for acquired symmastia? Yes, the treatment is surgical and may involve sulcus correction, implant exchange, or the use of flaps.
5. Can symmastia cause pain? In most cases, the discomfort is aesthetic, but some patients report discomfort in the region.
6. How much does corrective surgery cost? The cost varies according to the complexity of the case and the materials used. An in-person evaluation is necessary.
7. Can I prevent symmastia with postoperative care? Yes, avoiding exertion and following medical instructions helps prevent complications.
8. Does the choice of implant size interfere? Yes, implants that are too large for the chest increase the risk of symmastia.
9. Do I need to remove the implant to correct symmastia? Not always. In some cases, only repositioning is sufficient. But an exchange may be necessary.
10. Can symmastia return after correction? If done correctly and with proper care, the risk of recurrence is very low.

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