The difference between symmastia and breasts asymmetry

The difference between symmastia and breasts asymmetry

25th Aug 2017

Breast implant surgery can indeed dramatically improve your breast, but the other side of the coin is that complications can also arise out of it. Two of the possible complications that can happen are symmastia and asymmetrical breasts.

Symmastia, commonly referred to as “uniboob or bread-loafing”, is described as not having a clear distinction between the two breasts. On the other hand, breast asymmetry is having two breasts that are distinctly different from each other in terms of size, shape, and position. It may differ in various degrees but extreme asymmetry can push patients to seek surgical remedies.

When the muscle and skin appear to move away from the sternum, symmastia happens. This may be due to the over-dissection of the muscles or very large implants. The cause of asymmetry, on the other hand, is the malrotation of the implants or the failure of the implants to settle.

Both complications can be properly addressed with revision surgery. The revision surgery can correct the symmastia by suturing the muscle back to the sternum. The pockets are also fixed, and it is possible that smaller implants would replace the larger ones. On the other hand, breast asymmetry would be repaired by changing into round implants or by altering the pockets and the nipple or areolar region.

Breast Implant Surgery

The breast implant surgery is the choice of many to help improve the appearance of their breast by increasing size, shape or fullness. It results in bigger and more appealing breasts that can greatly boost the confidence of women. Although it produces satisfying results, complications could develop. Among the complications are symmastia and breasts asymmetry. The two complications are quite different from each other but there may be some who can’t tell one from the other. Let us take a closer look at these two complications.

Symmastia & Breast Asymmetry

Symmastia happens when the breast implants meet at the chest and come very close together. Some may even have the implants touching each other at the center of the chest. When this happens, it would look like the cleavage has been lifted off the sternum. This condition is also referred to as uniboob since there is no distinction between the two breasts. The skin, and in some cases, the muscles are lifted away from the sternum. This can cause pain and discomfort and should be corrected as soon as possible. Symmastia can also be congenital although the occurrence is very rare.

In comparison, breast asymmetry occurs more commonly among women with or without implants. Most women already have some degree of breast asymmetry even before they go through the surgery. Implants may enhance the asymmetry because the breasts are larger. Breast asymmetry is a condition in which the breasts are uneven. Some may have one breast larger or smaller than the other. The asymmetry may also have something to do with the size and position of the nipples.


Symmastia, after the breast implant surgery, has various causes. First of all, it can be caused by the over-dissection of the pectoral muscle. Those who are not well experienced in surgery may have done this in order to get more cleavage. Although you will get more cleavage, it is extremely likely that it will develop into symmastia sooner or later. Using larger implants for a patient with a small frame puts the patient at risk for developing symmastia. Symmastia can also occur in subglandular breast implants.

Breast asymmetry after the implant surgery can be temporary especially if the breast hasn’t completely healed. The implants may not have dropped or settled in their final position after the surgery was done. Implants do not settle down at the same rate and it would be best to wait and observe for about 4-8 months to conclusively determine if you have asymmetry.

Breast asymmetry can occur if one of the implants doesn’t really settle in the place where it is supposed to settle. It can also occur as a result of the malrotation of the breast implants especially if your implants are of the anatomical tuberous types. Breast implant malposition also causes breast asymmetry. It comes in varying degrees too. Some can be barely visible while others can be quite obvious.


Revision surgery is the only procedure that can correct either symmastia or asymmetry of the breasts. The revision surgery to be done comes in a variety of procedures. The surgery is customized to the current need of the patient.

For those who have symmastia, it is possible to move the breast implant under the muscles if it is just placed at a subglandular level. On the other hand, if the implants were already found on the submuscular level, there would be a need to repair the pockets first. The surgeon may also have to use a part of the breast implant capsule as support so muscles and tissues can be sutured to the sternum. This will bring the skin closer to the sternum and create a clear and distinguishable division of the two breasts. It is also possible to switch into smaller implants to prevent symmastia from recurring.

The asymmetrical breasts due to the implants can also be corrected through revision surgery. Those who have anatomical or tear drop shaped implants can have them replaced with the round implants to prevent future malrotation. Some also need their pockets fixed so that the implants can properly settle. It is also possible to fix the asymmetry by altering the nipples and areola to make the breasts look similar. It is important for patients to remember that asymmetry that isn’t too obvious can be left alone because breasts are naturally asymmetrical.


Women who go for breast implant surgery are looking forward to aesthetically improved breasts whose size, shape and fullness have been restored. Most of the time, the surgery is successful but there are times when it is not. It may develop complications like symmastia and asymmetrical breasts.

Symmastia happens when the patient develops a uniboob. In this condition, the muscle or skin is literally lifted off the sternum due to the very large implants or due to over-dissection of the muscles. On the other hand, asymmetry or striking differences of the breasts usually happens when there is malrotation of the implants or when it has failed to settle properly.

The only way to correct symmastia and significant breast asymmetry is to undergo revision surgery. The revision surgery for symmastia would involve suturing the muscles and tissues back to the sternum, fixing the pockets, and changing large implants into smaller ones. The asymmetry can be fixed by changing the implants into the round ones, altering the pockets or by adjusting and/or repositioning the nipples and areola.

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