• Symmastia Overview
  • Symmastia Video
  • Procedure Walk-Through
  • Symmastia FAQs

Symmastia Overview

What is Symmastia ?

Symmastia, also known as synmastia, is a rare variant of breast fold mal-position deformities and may occur secondary to over-dissection of the medial aspect of the breast pocket during breast enhancement surgery; it is seen in excessively thin patients with minimal amounts of native breast tissue, and has also been described in patients with pectus excavatum ( depressed breast bone ) – subsequently, many plastic surgeons, including Dr. Vallecillos recommend the use of smaller implants in patients with pectus excavatum.

Symmastia has many well described lay terms including “uniboob”, “breadloafing”, and “kissing implants” – When this condition occurs the breast implants becoming medialized and in some instances even touch, creating the appearance of one breast mound instead of two discrete ones.


Figure 1. – Symmastia



Procedure Walk-Through


When a diagnosis of symmastia is established, the typical course of treatment is to re-create the medial fold through breast revision surgery.  The techniques employed are similar to those of other breast fold deformities. A brief mention of some of the repair techniques is a made below.


  • Capsulorrhaphy – The internal lining, or breast capsule, is re-approximated to itself, to re-create the medial breast fold. Attempts are also made to re-attach breast muscle to the chest wall/sternum to give added support, although this is not always feasible.   This procedure is typically is typically performed in conjunction with Strattice™ implementation to lend to greater medial fold support.


Figure  – Medial breast pocket redefined with assistance of Strattice



  • Internal bolstering – In symmastia, internal bolstering is employed to help recreate the medial breast fold through the used of permanent sutures which are approximated to the sternum.  External bolsters may also be utilized to provide added support while the internal stitch work heals.  Dr. Vallecillos typically removes any external bolsters at post-operative day 10 – 14.


  • Strattice™ Reconstructive Tissue Matrix –  in cases where additional support is required to recreate the medial breast fold, a tissue matrix, such as Strattice™, may be utilized.  The product is derived from a porcine ( pig ) origin.  It is sterile, flexible, and incredibly strong. During surgery, Strattice™ may be attached to the chest muscle and to the existing fold to lend support and create a more anatomic breast shape and thus positioning the breast more ideally. An illustration of this is presented below.


Figure – Fold recreation with use of Strattice™ Tissue Matrix


Symmastia FAQs


Who should undergo surgery to repair symmastia ?

Patients who have developed symmastia secondary to a breast augmentation procedure or combination breast procedure such as an augmentation-mastopexy are candidates for medial breast fold recreation surgery.

What is the timeline to schedule repair of symmastia ?

In general,  it is best to wait a period of 12 months from the initial breast enhancement surgery prior to considering repair of symmastia.  Why ?: At the 12 month mark,  the breast capsule will typically be well formed, allowing for greater ease in surgical repair. Attempts to repair the medial fold at earlier periods may increase the risk of recurrence.

What are the benefits of surgery to repair symmastia ?

The primary benefit of symmastia surgery is to recreate the medial breast fold and in doing so, regaining the natural contour of the breast.

What are the typical incisions used to correct IMF disruption ?

The surgical correction is generally performed through the initial surgical incision, although not in all instances. Dr. Vallecillos will best determine where the incision should be made to ensure the greatest chance of a successful corrective surgery.

Can surgery to repair symmastia be avoided?

Symmastia repair is purely an elective procedure and thus an elective decision –  Dr. Vallecillos will discuss your options, risks, and benefits of surgery with you during the consultation.

What is the typical recovery from symmastia repair surgery ?

The recovery from symmastia surgery is similar to that of other variants of breast fold repair surgery.  The patient must refrain from lifting greater than 10 lbs or upper body exercise for no less than 8 weeks –  this will allow for maximal “take” of the repair, increasing the chances of a successful outcome.  Additionally, external bolsters, if utilized, will be removed between the 10 – 14th  post-operative day.

Why choose Dr. Vallecillos for symmastia repair surgery ?

Dr. Vallecillos is a Beverly Hills board certified plastic surgeon with a practice emphasis on breast revision surgery, including symmastia repair surgery. Call the offices of Dr. Vallecillos today to schedule a consultation.


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