Is symmastia always related to implants?
No. It can be present naturally or develop after breast implant surgery.
The repair depends on whether the connection involves natural tissue, implant pockets, or both.
Breast & Chest
Symmastia Correction
Symmastia correction is surgery to restore separation between breasts when skin, tissue, or breast implants extend across the center of the chest.
Will I need new implants?
Not necessarily.
Your surgeon may discuss keeping, downsizing, exchanging, or removing implants depending on the pressure they place on the planned repair.
Can the separation disappear again?
Yes. Symmastia can recur after correction.
Tissue strength, implant size, previous operations, and healing all influence how well the repair holds.
01 · Overview
Understanding symmastia correction
Symmastia means the breasts appear connected across the breastbone. In a naturally occurring case, skin and soft tissue may bridge this area. After augmentation, an implant pocket may extend too far toward the center, allowing an implant to shift inward.
For implant-related symmastia, correction is a form of breast implant revision. The surgeon may reshape the pockets, repair supporting tissues, and change the implants when needed. Revision surgery is tailored to the existing implants, tissues, and goals. [1]
Symmastia is not simply close-set breasts or prominent cleavage. It also differs from implants sitting too low or too far apart. An examination helps distinguish these concerns and determine whether surgery could offer a reasonable improvement.
- Procedure type
- Individualized breast or implant-pocket repair
- Main goal
- A more defined space between the breasts
- Anesthesia
- Often general anesthesia; confirmed with your team
- Recovery
- Protected healing followed by a gradual return to activity
Why does the cause matter?
Natural tissue bridging and an implant pocket that crosses toward the breastbone need different solutions. Tightening an implant pocket alone will not address every naturally occurring case.
What can make correction more complex?
Thin or stretched tissue, larger implants, scars from earlier repairs, and multiple previous operations can limit support. Your surgeon may recommend a staged approach rather than trying to make every change at once.
02 · Concerns & Goals
What may bring you to a consultation
You may notice that the space between your breasts has changed or has never been clearly defined. A consultation can help explain what is causing it.
Loss of central separation
The skin over the breastbone may look lifted, or the breasts may appear joined rather than distinctly separated.
Implants shifting inward
One or both implants may sit too close to the center, sometimes with uneven positioning.
Difficulty with bra fit
The center of a bra may not sit as expected. A repair may change fit, but a particular bra size or style cannot be promised.
Changes after an earlier repair
A returning connection or persistent asymmetry may lead you to seek another opinion. Previous operative records can help guide that discussion.
03 · Options
How the approaches differ
These approaches may be combined. The right plan depends on the cause of the symmastia, tissue strength, and whether you want to keep implants.
Implant-pocket repair
Reshapes and closes the overly wide inner portion of an implant pocket.
How it worksInternal sutures tighten the pocket boundary; selected cases may also need a different pocket location.
May suitSome people with implant-related symmastia and tissue that can support a repair.
Main tradeoffSutures can pull through weakened tissue, and inward shifting can return.
Repair with added support
Reinforces a repair when the existing tissues provide limited support.
How it worksThe surgeon may use a tissue-derived scaffold or surgical mesh alongside pocket reconstruction.
May suitSelected complex or recurrent cases after discussion of the specific product and its intended use.
Main tradeoffAdded materials can increase cost and introduce risks such as infection, fluid collection, or problems with tissue integration.
Implant exchange or removal
Changes or removes an implant that contributes to pressure on the center of the chest.
How it worksSmaller or differently sized implants may accompany pocket repair. Removal, with or without later reshaping, is another option.
May suitPeople willing to change breast size or stop using implants to support their treatment goals.
Main tradeoffBreast volume and shape will change. Loose skin, dents, or a need for additional surgery may remain.
Natural-tissue correction
Addresses symmastia that is present without implants.
How it worksSelected plans may combine removal of central excess tissue with fixation of skin or soft tissue to restore the central contour.
May suitPeople whose examination confirms naturally occurring tissue bridging.
Main tradeoffScars, contour irregularities, and incomplete or recurrent bridging are possible; more than one operation may be needed.
Breast implant revision can include pocket adjustment, implant exchange, or removal. Symmastia requires a more specific plan than a routine implant exchange. [1].
Does every repair need mesh?
No. Ask why added support is being recommended, which product would be used, its regulatory status for this use, and its risks and alternatives.
Can I keep the same breast size?
Possibly, but keeping the same implant may place too much stress on some repairs. Your surgeon should explain the balance between your preferred size and the support your tissue can provide.
04 · Results
What may improve and what may remain
Central contour
The aim is clearer separation, not a guaranteed cleavage shape.
- Chest anatomy and skin attachment limit the contour that can be created.
- Some central fullness or asymmetry may remain.
Breast size and position
A stable repair may require a change in implant size or breast shape.
- Downsizing or removing implants can reduce volume.
- Additional reshaping may be discussed if skin remains loose.
Long-term stability
A repair can improve position, but recurrence is possible.
- Healing and tissue strength affect durability.
- Future implant problems or recurrent symmastia may require further surgery.
Revision results take time to settle, and further surgery may sometimes be needed. Implants are not lifetime devices. [1]
05 · Recovery
Planning your recovery
Recovery at a glance
- Stay after surgery
- Determined by Your Surgeon
- Initial recovery at home
- Varies by Individual
- Return to desk work
- Varies by Procedure and Work Activity
- Light daily activities
- Based on Individual Recovery
- Strenuous exercise
- Based on Surgeon Clearance
Returning to work does not mean fully healed. Follow your surgeon’s instructions; strenuous activity requires clearance.
Recovery depends on how much tissue is repaired, whether implants are changed, and whether added support is used. Your surgical team's instructions take priority over general timelines.
Step 1 · Day of surgery
Treatment day
You will be monitored after anesthesia. Dressings, a support garment, or drains may be used depending on the repair. Arrange an adult escort and help at home as directed.
Step 2 · First days
Early protection
Soreness, swelling, bruising, and tightness are common. Your team will explain wound care, medication use, and how to avoid pressure or movement that could strain the central repair.
Step 3 · Following weeks
Gradual activity
Follow-up visits help guide a return to work and everyday movement. Feeling ready for desk work does not mean the internal repair has fully healed.
Step 4 · Following months
Settling and scar care
Swelling and scars change gradually. Your surgeon will assess the central contour and decide when exercise, usual bras, and other activities are appropriate.
Planning everyday activities
ActivityGeneral planning contextWhat affects the plan
Desk workPlanning context: Timing depends on discomfort, fatigue, medications, and your job. [2]What affects it: Plan flexibility rather than treating a return-to-work date as complete healing.
Lifting and chest exercisePlanning context: These can put tension on a healing pocket repair.What affects it: Ask for specific limits and clearance before increasing activity.
DrivingPlanning context: Pain, restricted movement, and sedating medicines can impair safe driving.What affects it: Resume only when you can control the vehicle safely and your team agrees.
Bras and sleeping positionsPlanning context: Pressure across the center of the chest may affect the repair.What affects it: Use only the garment and positioning plan recommended for your operation.
A central support garment or taping may be prescribed for some repairs; do not improvise tight compression. Ask your surgical team whether compresses are appropriate and exactly how to use them.
Before your procedure
- Bring prior breast surgery reports and implant information if available.
- Discuss whether keeping your current breast size is a priority.
- Review medicines, supplements, allergies, and previous anesthesia problems with your team.
- Discuss nicotine use and the team's requirements for stopping before and after surgery.
- Ask whether breast imaging or other testing is needed before the operation.
- Arrange transportation, home support, and time away from lifting or demanding work.
Will I need drains?
Some repairs use drains and others do not. If you need them, your team will explain how to care for them and when they can be removed.
What if the center looks swollen again?
Swelling can temporarily blur the separation, but a new or increasing change should be reported. Do not try to reposition an implant, massage the area, or tighten a garment unless your surgeon directs you.
06 · Safety
Risks and what your clinician assesses
Temporary soreness, swelling, bruising, tightness, and altered sensation can occur. Symptoms should generally improve; worsening pain, rapid swelling, or skin changes need prompt assessment.
Recurrent or incomplete correction
The central connection may remain or return, and another operation may be needed.
Bleeding or fluid collection
Blood or fluid can collect around the repair and may require drainage or further surgery.
Infection or wound problems
Infection, delayed healing, or skin damage may require treatment and sometimes removal of an implant or support material.
Scars and contour changes
Visible scars, dents, uneven breast position, or an unexpected change in cleavage can occur.
Sensation and implant complications
Nipple or breast sensation may change. If implants remain, firm scar tissue around them, rupture, and other implant-related problems remain possible.
Anesthesia and blood clots
Anesthesia reactions and clots in the legs or lungs are potential surgical complications.
Discuss these risks and your individual health history with your surgeon. [3]
What your clinician assesses
- Whether the connection comes from natural tissue, implant pockets, or both
- Skin thickness, scars, tissue support, and any previous failed repairs
- Implant size, position, condition, and your preferences about exchange or removal
- General health, nicotine use, healing history, and clotting or anesthesia risks
07 · Costs
What makes up the Total Procedure & Care Cost
Compare written estimates for the same planned scope: pocket repair alone can involve different services from implant exchange, added support, or staged reconstruction.
Surgeon
Surgical care
The surgeon's work for the agreed repair and any planned implant or tissue changes.
Ask your surgeonAsk whether implant removal, exchange, reshaping, or a later stage is included.
Facility
Anesthesia and facility
Anesthesia services and use of the operating and recovery facilities.
Ask your surgeonAsk whether these are separate bills and how changes in operating time are handled.
Supplies
Supplies and follow-up
Potential charges for implants, support materials, garments, medications, and postoperative visits.
Ask your surgeonAsk which items are included and how unexpected treatment or revision would be charged.
TRC
Patient Services
Any separately listed coordination or administrative services.
Ask TRCAsk whether a fee applies, what it covers, and whether it is optional.
Your written estimate should explain the services included, any separate charges, and payment terms.
08 · Questions
Common questions
Is symmastia correction the same as a breast lift?
No. A lift addresses breast drooping and nipple position. Symmastia correction addresses the connection across the breastbone. Some people may discuss both, but one does not automatically solve the other.
Can exercise or massage fix it?
Exercise cannot close an overly wide implant pocket or reliably restore central skin attachment. Massage may strain a repair and should only be done if your surgeon specifically recommends it.
Where will the scars be?
Existing breast incisions may be usable for implant-related repair. Naturally occurring symmastia or more complex reconstruction may require different incisions. Ask your surgeon to show you the proposed locations.
Will insurance cover correction?
Coverage depends on your policy, the cause of the problem, and the proposed treatment. Ask your insurer about documentation and prior authorization; coverage should not be assumed.
0 consultation questions in your plan
View in My TRC workspaceMy Aesthetic Plan
Prepare for your consultation
Bring these to help your consultation:
- Understand the cause, proposed repair, and alternatives.
- Confirm implant choices, recovery restrictions, and follow-up arrangements.
- Review the written estimate and the plan for complications or recurrence.
View My Aesthetic Plan
Choices stay in this visit until saving to your account completes. Nothing is sent to a clinician.
Sources
- [1]American Society of Plastic Surgeons — Breast Implant RevisionGeneral implant revision goals, individualized pocket and implant changes, possible additional surgery, and the fact that implants are not lifetime devices.
- [2]American Society of Plastic Surgeons — Breast Implant Revision RecoveryIndividualized postoperative instructions, dressings, support garments, possible drains, and surgeon-guided return to activity.
- [3]American Society of Plastic Surgeons — Breast Implant Revision Risks and SafetyGeneral revision risks including bleeding, infection, poor healing, sensation changes, asymmetry, implant complications, anesthesia risks, blood clots, and urgent assessment for breathing difficulty or chest pain.
Photographs are illustrative scenes, not patients, staff, facilities or outcomes. This information does not replace a personal assessment by your treating clinician.