SYMMASTIA

Symmastia, also known as “bread loafing” or “uni-boob,” occurs when the breasts converge in the middle of the chest, forming a single mass rather than distinct breast mounds. Symmastia is characterized by breasts growing together with little or no cleavage between them, resulting in a web of skin, fat, and tissue across the cleavage area. There are different degrees of this condition, and sometimes the lack of cleavage is less noticeable.

This condition can occur congenitally or as a complication of breast implant surgery, though it’s relatively rare.

Causes of Symmastia

1. Congenital Symmastia: This type of uni-boob,occurs when an individual is born with the condition. It is rare, and the exact cause is unknown.
2. Acquired or Iatrogenic Symmastia: This type is more common than congenital symmastia and typically arises as a complication of breast reconstruction or augmentation surgery. Several factors can contribute to acquired symmastia:
   • Placement of Breast Implants: If breast implants are positioned too close together, especially if they are too wide for the individual’s anatomy, it can increase the risk of symmastia.
   • Multiple Surgeries: Individuals who have undergone several breast reconstruction surgeries have a higher risk of developing acquired uni-boob.
   • Surgical Complications: Accidental cuts or improper techniques during the implant placement process can result in symmastia. Surgeons must create a pocket for the implant, typically using tissue from another part of the body. If the pocket is too large or the incisions are made incorrectly, the two pockets can merge, leading to symmastia.
   • Tissue Sources: In some cases, surgeons may use animal tissue, often from a pig, if the patient’s own tissue is not suitable. However, improper placement or sizing of the implant and tissue can contribute to the development of symmastia.

Treatment for Symmastia

1. Surgical Correction: Surgical intervention is often necessary to address uni-boob, particularly in cases where it causes cosmetic concerns. Treatment options may include:
   • Skin Reattachment: Surgeons reattach the skin at the cleavage area to the breastbone to redefine the cleavage and separate the breasts.
   • Creation of New Implant Pockets: In some cases, surgeons may need to create new pockets to hold implants or replace existing implants with narrower ones to prevent them from being too close together.
   • Three-Step Procedure: A common technique for treating congenital symmastia involves a three-step procedure. The first step involves removing a small amount of breast tissue using liposuction or surgery. Then, the surgeon attaches the skin at the cleavage area to the breastbone. Finally, compression is applied to aid in healing, and the patient may need to wear a compression bra for a period. Possible complications include scarring and asymmetry of the breasts.
2. Non-Surgical Approaches: Non-surgical methods for addressing uni-boob, are limited and may not be as effective as surgical correction. However, options such as wearing supportive bras or compression garments may help manage symptoms in some cases.

Prevention

• Careful Surgical Planning: If considering cosmetic breast surgery, careful planning with the surgeon is essential to ensure the appropriate type and size of implants are chosen based on the individual’s body characteristics. It’s crucial to select a surgeon experienced in performing similar procedures to minimize the risk of complications.
• Second Opinion: Before undergoing surgery, it’s advisable to seek a second opinion from another qualified surgeon to ensure informed decision-making and explore different treatment options.

uni-boob treatment typically requires the expertise of a skilled plastic surgeon who can tailor the approach to the individual’s specific needs and desired outcomes.

Sources:

1. Breastcancer.org: “Symmastia”
2. Up to Date: “Complications of reconstructive and aesthetic breast surgery.”
3. American Cancer Society: “Breast Reconstruction Using Implants.”
4. Australasian Society of Aesthetic Plastic Surgeons: “Achieving the Breast Job for Patients.”
5. Plastic and Reconstructive Surgery Global Open:
   • “Congenital Symmastia: A 3-Step Approach”
   • “Five-Step Correction of Congenital Symmastia”
6. Annals of Medicine and Surgery: “An efficient method for the correction of iatrogenic symmastia: A case series.”
7. Journal of Plastic, Reconstructive & Aesthetic Surgeons: “Congenital symmastia revisited.”
8. Aesthetic Surgery Journal: “Iatrogenic Symmastia: Causes and Suggested Repair Technique.”