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Synmastia or breasts connecting in the middle

Synmastia is a very rare but difficult problem that can occur after breast implants have been placed. It can also be seen in women who have very large breast naturally. With breast implants, synmastia occurs because the pocket where the breast implants are positioned is too large in the midline. When this occurs, it lifts up the skin that normally is attached down to the breast bone or sternum. This causes a loss of cleavage and the skin is tented up off of the chest. The term technically means ‘one breast’ and this is what it can look like. There will be one breast literally connecting with the other so they can appear combined.

The time of synmastia to occur can be quite variable. Synmastia may occur shortly after breast implants have been placed or months later. Correcting the synmastia is important and should be done as soon as possible. The longer the breast skin is allowed to be stretched, the harder the repair is and the more likely a second stage will be required to fully restore a naturally looking breast mound. When the breast implants are allowed to remain with towards the midline for a long time, the nipple and areolas may be significantly malpositioned outward.

The surgical correction of synmastia requires removing the breast implants and sewing the tissues down to the chest wall. This can be a difficult procedure and requires a great deal of patience from the effected woman. There is usually a long recovery of 2-3 months. The breast implants are typically put back in during the initial repair but in some cases it may be best to leave the breast implants out for a few months and then replacing them.