Understanding Symmastia: Causes, Treatment, and Prevention

Symmastia is a rare condition where the breasts grow together, resulting in little or no cleavage between them. Instead of a clear separation, there is a web of skin, fat, and tissue across the cleavage area. The severity of this condition can vary, with some cases being less noticeable than others.

Causes of Symmastia

There are two main types of symmastia, each with different causes:

1. Congenital symmastia: This type is present from birth and is extremely rare. The exact cause of congenital symmastia is unknown.

2. Acquired or iatrogenic symmastia: This type is more common than congenital symmastia but still rare. It usually occurs as a complication of breast reconstruction or augmentation surgery. Factors that can contribute to acquired symmastia include:

   • Breast implants that are too close together or too wide for the individual's body

   • Multiple breast reconstruction surgeries

   • Accidental cuts during the implant process

During breast augmentation or reconstruction, surgeons create pockets to hold the implants using the patient's own tissue, animal tissue (usually from a pig), or synthetic materials. If the pockets are too large or if cuts are made incorrectly, the two pockets can merge, forming a single large space and resulting in symmastia.

Treatment Options for Symmastia

While symmastia does not typically cause serious health problems, some individuals may choose to address the condition for cosmetic reasons. Treatment options depend on the type of symmastia and the individual's specific case.

For both congenital and acquired symmastia, surgery often involves reattaching skin to the breastbone to redefine the cleavage. In cases of acquired symmastia, surgeons may also need to create new pockets for implants or replace existing implants with narrower ones.

Treating congenital symmastia can be more complex, as surgeons must address both the structure and size of the breasts. Experts have not reached a consensus on the best surgical approach, as different techniques may be more suitable for different individuals. Generally, surgery should be postponed until breast growth is complete.

One successful technique for treating congenital symmastia involves a three-step procedure:

1. Removing a small amount of breast tissue through liposuction or surgery

2. Attaching the skin at the cleavage area to the breastbone

3. Compressing the area to facilitate healing of the skin and chest wall

After surgery, patients will need to wear a compression bra to support the healing process. Potential complications include scarring and asymmetry in breast size or shape.

Preventing Symmastia in Cosmetic Breast Surgery

For individuals considering cosmetic breast surgery, there are steps both the patient and surgeon can take to minimize the risk of developing symmastia:

• Discuss the type and size of implant and ensure it is suitable for the individual's body

• Choose a surgeon with extensive experience in similar procedures to reduce the likelihood of surgical errors

It is essential to seek a second opinion from another surgeon before committing to a procedure and to select a surgeon with a proven track record of successful surgeries.

In conclusion, symmastia is a rare condition that can be congenital or acquired, often as a result of complications from breast augmentation or reconstruction surgery. While treatment options are available, prevention through careful surgical planning and experienced surgeons is key. If you are considering cosmetic breast surgery, be sure to discuss the risks and benefits with your surgeon to make an informed decision.

For more information on symmastia and breast health, visit:

• American Board of Cosmetic Surgery - Symmastia Repair

• American Society of Plastic Surgeons - Breast Augmentation

• Breastcancer.org - Symmastia