A Strange Breast Augmentation Complication: Uniboob
If you’re planning breast augmentation here in NYC or anywhere, you probably know there are possible complications. These run from the occasional, such as extra fluid build up after surgery (called a seroma), to the unusual, such as when an implant drops and causes “double bubble.”
Perhaps the strangest complication than can occur is symmastia. It’s also called “breadloafing,” “kissing implants” and “uniboob.” If you can’t figure it out from the nicknames, symmastia is a condition in which one or both breasts cross the midline of the chest. It can range from mild, when the implants simply look too close together, to severe, in which the implant pockets actually connect.
How Does Symmastia Happen?
An article in a 2011 issue of Plastic and Reconstructive Surgery, the journal of the American Society of Plastic Surgeons, proposed this definition: “disruption of the midsternal fascia.” This means the tissue that attaches the skin between the breasts to the sternum has been detached, or “over dissected,” to some extent.
Sometimes spelled “synmastia,” the complication can occur due to surgical error. Other times, it can be the result of the surgeon attempting to create or increase cleavage as a patient has requested.
Women who are thin are somewhat more prone to symmastia since they have scant tissue covering the breastbone. Women with a depressed sternum and concave chest, called “pectus excavatum,” are also more at risk as their breast implants will tend to lean toward the middle of the chest.
Can Symmastia Be Fixed?
Symmastia can become apparent shortly after surgery or later. It can be repaired, though the procedure is not necessarily easy and must be carefully tailored to the patient.
For some patients, the best repair method is to reattach skin and fat to the sternum. This closes pockets that have become too wide. In recent times, plastic surgeons have also used a technique called “neosubpectoral pockets.” This means new implant pockets are created under the muscle. The U.S. National Library of Medicine published an online article a few years ago calling this strategy “efficient, accurate and effective.”
There are a variety of variations of these two approaches, and there are support products available to strengthen repair sites as needed. Often referred to as “tissue matrix” products, they are made from human or porcine cells.
How Worried Should You Be About Symmastia?
The great news is that symmastia is a rare outcome of breast augmentation surgery. In cities like NYC, breast augmentation surgeons with plenty of experience are abundant. If you choose a board certified plastic surgeon with evidence of a good track record, you should have nothing to worry about.
One word of advice: if you have a depressed sternum and are quite thin, be sure to discuss implant strategy with your plastic surgeon. Do your best to choose the implant size and placement that’s appropriate—this will help ensure you don’t end up with a “uniboob.”
As always, we would be happy to meet you and discuss your needs. We have thirty years of experience with breast augmentation in NYC and revision surgery of all types. Give us a call at 212-570-6080 if you would like to make an appointment.
