Close up of a female in white bra

A uniboob generally refers to a lack of distinction or cleavage between a woman’s breasts. Sometimes used jokingly when a woman’s bra or clothing blurs the shape of the breasts, the uniboob is seen as less than aesthetically pleasing—but a uniboob is more than just an aesthetics problem when it is a complication of breast augmentation surgery. Keep reading to learn more. 

Is it a Uniboob or Symmastia?

For many women, the ideal breast appearance is two distinct, separated breasts with an attractive amount of cleavage in the middle. This ideal is often the reason many women seek breast augmentation in the first place, which makes symmastia, or a “uniboob,” so frustrating.

While the appearance of a singular breast can occur due to constricting sports bras, certain clothes, or ill-fitting bras, none of this is true symmastia. Below, we will discuss what a medical uniboob, or symmastia, is, how it occurs, and how it is treated.

What Is Symmastia?

Symmastia is a rare development in which the skin, tissue, and muscle between the breasts lift away from the sternum, causing the breasts to move inward together. This results in a loss of cleavage or space between the breasts, often appearing as a singular “uni-boob” instead of two distinct breasts. The characteristics of symmastia include:

  • The breasts appear too close together
  • The skin and tissue between the breasts appear lifted away from the chest wall (almost like a webbing)
  • Patients may feel pain or discomfort
  • Symptoms may occur right after surgery or much later

There are varying degrees of symmastia, including pseudo-symmastia, which may result in slightly more distinction between the breasts, although still without a normal breast appearance. The amorphous lumping of the breasts together can also occur due to improper bra size or style, although this is not considered true symmastia as it is not an effect of changes in the tissue or structure of the breasts.

What Causes Symmastia?

Although some women are born with a lack of space between their breasts, symmastia is most often caused by an issue after some form of breast surgery, such as breast augmentation or breast reconstruction after mastectomy. But within those categories, there is still more cause for distinction, as healing complications, poor surgical decisions, a lack of surgical skill, or implants that are too large can all play a role in the development of symmastia or pseudo-symmastia.

Symmastia from Breast Augmentation

Most patients exhibiting true symmastia are experiencing issues due to a previous breast augmentation procedure. During a routine breast augmentation, the surgeon needs to create a small pocket or empty space in which to place the implants, called the breast implant pocket.

There are generally three options for creating a breast implant pocket: subglandular (over the muscle but under the breast tissue), submuscular (under the pectoralis muscle and the breast tissue), or, less commonly, through a dual plane placement (partially below and partially above the muscle.

In order to create the breast pocket–using any of the aforementioned methods–some amount of tissue must be removed. The problem occurs when the surgeon removes too much tissue in an attempt to fit large or overfilled implants or simply due to a lack of experience. If too much tissue is removed, or the excision occurs too close to the midline of the breasts, the implants and breast pocket will gradually slope inward, eventually lifting or pulling the skin and connective tissues. When left untreated, symmastia gets progressively worse, in some cases causing the breast pockets to fuse and eliminating the space between the breasts altogether.

Congenital Symmastia

Much less common is congenital symmastia, which is a medical anomaly when the tissue between the breasts is webbed, resulting in little to no cleavage or separation between the breasts.

How Is Symmastia Treated?

Symmastia poses no real health threats or concerns–it’s usually an entirely aesthetic issue. But that doesn’t mean that symmastia treatment is not important. Many women seek breast augmentation to better their sense of confidence and empowerment, as well as achieve some level of aesthetic satisfaction. Symmastia, through no fault of the patient, effectively ruins the results that patients thought they’d have!

There’s still hope. Symmastia treatment closely depends on the type of symmastia you have, as well as how advanced your condition is. Your plastic surgeon will likely perform a breast implant revision procedure to remedy the problem. Some possible surgical options for symmastia repair include:

  • Creating new breast pockets below the pectoral muscles if the primary augmentation used above the muscle placement
  • Creating new pockets above the muscle, if the primary augmentation used below the muscle placement
  • Repairing the cleavage by using part of the implant pocket to reattach the breast tissue and muscles to the sternum
  • Possibly tissue grafting from another area of the body can repair the sternum area

Can You Prevent Symmastia?

While it’s true that patients have limited control over preventing symmastia, there are factors within their influence. For instance, choosing a board-certified plastic surgeon with extensive experience can significantly reduce the risk. By reassuring patients about the steps they can take to minimize the chances of symmastia, they can feel more empowered and proactive about their health.

So, while you may have a goal for your breast augmentation result, it’s important that your plastic surgeon can guide you in the right direction to avoid potential problems with implant size or placement.

The best way for you, as the patient, to avoid symmastia or other complications is to choose a board-certified plastic surgeon with extensive experience performing successful breast augmentations as well as other breast procedures, such as breast implant revision. Not only do you want to ensure a safe and pleasing outcome, but choosing a surgeon who has experience with breast surgeries gives you peace of mind that they have the tools and understanding to advise you on the best size and projection of implants for your frame to avoid complications.

Dr. Allen M. Doezie is board-certified by the American Board of Plastic Surgery and has served his community since 2004, offering expert guidance and care for all of his patients. Dr. Doezie can help you determine the best choice of breast implant option that will help you reach your aesthetic goals but will also be a safe and comfortable result.

Want to Learn More About Symmastia or “Uniboob” Treatment in Ladera Ranch, CA?

Dr. Doezie is prepared to help patients with symmastia see results they can be proud of. With a range of treatment options through breast implant revision, we can help your aesthetic goal become a reality. Call (949) 481-9850 or fill out our online contact form to get started.