Dr. Lavinia Chong is a highly sought out Newport Beach plastic surgeon as a result of her experience and artistic touch with revising breast augmentation complications. One such complication, symmastia, is a rare condition where the breasts are confluent, joined together in the middle of the chest. This lack of separation causes the breasts to look like what is often referred to as a “uniboob”. While this implant malpositioning can be difficult to repair, revisional options do exist

Symptoms of Symmastia

Symmastia can occur naturally, but more often, it develops following breast augmentation. This condition is not always due to implants that are too large but can also be caused by poor positioning or support.

Symptoms associated with symmastia include:

  • The appearance of a “uniboob” or one continuous breast
  • Breasts that appear unnaturally close together
  • Little to no cleavage between the breasts
  • The skin has separated from the breastbone
  • Pain or discomfort

How to Fix Symmastia With Surgery

A separator bra may be a non-surgical fix, but it will not correct the underlying issue or provide long-term results. Surgery is necessary to create appropriate spacing between the breasts and hold them securely in place. A popular option uses biological mesh such as Strattice to form an internal bra structure that enhances support and reinforces the breast pocket while maintaining a natural appearance. However, treatment is tailored to each patient’s unique needs and condition.

What is Symmastia and Breast Implant Malposition?

Symmastia is a condition when the breasts are too close together and can occur naturally (congenital) or following breast augmentation, using an implant, which is too wide for the patient’s chest.

Features of Symmastia include:

    • Loss of medial (inner) cleavage lines;
    • one continuous “uniboob;
    • Unnaturally close appearance;
    • Skin lifting off the sternum (breastbone);
    • Difficulty with what to wear
    • Pain or discomfort is rare

When breast implants become positioned too closely together, the result is a lack of cleavage. The goal of your primary breast augmentation may have been an increase in cleavage. However, in trying to achieve this goal you may have ended up looking like you have one continuous breast, or breasts that are unnaturally close to each other. The results are not the desired surgical outcome.

Diagram of symmastia | lavinia k chong m D

There exist certain risk factors making some patients more susceptible to complications than others. Historically, patients who are at higher risk for developing symmastia are thin, whose breastbone curves inward, and who have larger implants. Understanding the role of patient anatomy is key in developing a plan for symmastia repair. As a female plastic surgeon, Dr. Lavinia Chong is among the most popular plastic surgeons in Newport Beach and Southern California for breast revision surgery. 

The “thong” bra which separates the breasts is a non-surgical, temporary, unsatisfactory result. Surgery is the gold standard, during which time the borders of the breast are restored and maintained with the use of DuraSorb, a biodegradable mesh and exchange for a narrower base implant.

These are challenging cases and require technical expertise as well as sensitivity in guiding the patient through the postop convalescence; all of which Dr. Chong and her team are well equipped to provide. Thankfully, patients generally report that pain is less than their primary augmentation. Postop protocols require the use of the thong bra and avoidance of upper body exercises for a minimum 90 days.

Dr. Chong did a fabulous job and I only wish I had known about her sooner. She is down to earth which made me very comfortable speaking with her of the procedure I wanted. She discussed everything in full detail and has her staff provide all costs very clearly. I highly recommend Dr. Chong for any cosmetic surgery needs” -JoAnn R. (Patient since 2010)

The Consultation Process

Symmastia repair requires revisional breast surgery. During your consultation, Dr. Chong will review your specific case taking into consideration the condition of the tissue surrounding the breast implant, the measurements of your chest wall, and the current sizing of your breast implant. Dependent on these variables, she may discuss options surrounding a capsulotomy, capsulectomy, capsulorrhaphy, and/or the use of an ADM (Acellular Cadaveric Dermal Matrix) such as Strattice, or the use of a Macroporous Monofilament Mesh such as Durasorb. She may discuss options to place subglandular implants submuscular. There is no standardized approach to symmastia repair, each case is unique and a surgical plan is developed based upon the individual needs of the patient.

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The Procedure

Preparing for a revisional breast procedure is very similar to how you prepared for your initial breast augmentation procedure. You’ll need to fast for at least 12 hours prior to arrival at our Orange County Surgical Suite. When you arrive, our pre-op surgical team will take your vital signs and prepare you for surgery.

Symmastia Repair

When breasts sit too closely together, whether naturally or following breast augmentation, there may be little to no visible cleavage, creating the appearance of one large breast. Dr. Chong performs revision surgery to improve spacing by adjusting where the skin attaches, creating a defined breast pocket, and increasing support using Strattice biomesh to hold your breasts securely in place.

Capsulectomy Repair

Breasts should be soft and supple, but excess scarring following implant surgery can leave them feeling hard and even painful. A capsulectomy removes scar tissue and replaces (or removes) your implant to correct these issues and leave you with breasts that once again move and feel as natural as possible.

Multi-Procedural Approach to Correct Asymmetry

Depending on the extent of the asymmetry, multiple procedures may be combined, such as a breast lift and reduction as well as augmentation using a breast implant or fat grafting. This can create greater balance in breast size, shape, and positioning to restore confidence and enable a more active, comfortable lifestyle.

During your surgery for symmastia repair, you will not have to undergo general anesthesia. Rather, Dr. Chong and her team of anesthesiologists use a lighter form of MAC (monitored anesthesia care), utilizing more rapidly metabolized sedatives. With MAC anesthesia, you breathe on your own, without a breathing tube.

“I have been a patient of Dr. Chong’s since 1999 and have referred friends to her since then. I’ve received many compliments on my breast augmentation and friends have asked me for Dr. Chong’s phone number for a consultation” -Lupe C. (Patient from Healthgrades)

After Dr. Chong has completed your breast surgery, you will be transferred to a private recovery room, where you are monitored by the nursing staff. Most patients will wake up within several minutes after the surgical procedure is completed. This means that you’ll have a pleasant sleep experience without the heaviness or nausea of general anesthesia.

If you have traveled to Newport Beach to work exclusively with Dr. Lavinia Chong to address your case of symmastia, it may be recommended that you stay nearby while you recover. You will be seen by Dr. Chong and a member of her staff the day immediately following surgery. Please inquire with our Practice Administrator about local recovery facilities, hotel options, and in-room nursing care if you are needing assistance beyond that of friends and family the evening following your surgery.

What should you do if you suspect you have a case of Symmastia?

Using procedures pioneered in breast reconstruction, Dr. Chong has helped many women get the natural-looking breast enhancement they have always wanted. If you think you have symmastia, or that your breast augmentation has resulted in your breasts being unnaturally close together, it is advised that you follow up immediately with your original surgeon. If you would prefer to meet with Dr. Chong to discuss options surrounding a capsulotomy, capsulectomy, or capsulorrhaphy as a means to repair symmastia, we advise calling to schedule as soon as possible. As a female plastic surgeon in Newport Beach specializing in breast procedures, her services are in high demand and appointment slots fill quickly.

Symmastia Repair FAQs

What is Strattice?

Strattice is a collagen scaffolding used for symmastia repair. As a biomesh, Strattice will soften and become part of the breast flap. This planned surgical approach reinforces deficiencies by repairing and supporting soft tissue, redefining the space occupied by the breast implant. It serves as a hammock, creating much stronger support for the implant. Dr. Chong’s experience with Strattice has provided her patients with a durable, powerful, soft solution to revisional breast surgery.

Capsulotomy, Capsulectomy, or Capsulorrhaphy?

There is often confusion surrounding these three terms. Breast revision may involve opening/scoring the capsule surrounding the breast implant, the capsule may be removed, or the size of the pocket may be reduced and recontoured. The details of your proposed surgical plan will be discussed and explained during your consultation with Dr. Chong. When preparing for your consultation, please bring any previous operative reports and current implant information to discuss with Dr. Lavinia Chong and her surgical staff in Newport Beach.

Do I Have to Replace My Implants?

Many Newport Beach women who experience symmastia maintain their current desire for augmented breasts. Dr. Chong’s primary focus is to help women experiencing symmastia regain their path toward the physical perfection they were originally seeking. However, it is often suggested that the patient look to a new implant shape, size, and/or profile to help them achieve their desired look.

Choose Dr. Chong for Symmastia Repair in Newport Beach

Newport Beach is a popular beach destination located in Southern California’s Orange County. Whether you live in Orange County, neighboring Los Angeles, or San Diego County, or are traveling from out of state you should recognize that symmastia is a rare complication of breast augmentation. Not all plastic surgeons have focused on developing their revisional breast skills and therefore may not be adequately prepared to repair this rarely occurring breast augmentation complication. Dr. Chong, however, is among the top class of plastic surgeons for breast revisions.

To schedule your consultation with Dr. Lavinia Chong, call her Newport Beach office at (949) 644-1400 today!