A beautiful décolleté underlines the femininity of the woman. The depression between the breasts is considered sensual and is therefore accentuated with various garments such as ball gowns, evening dresses, lingerie and swimwear. The groove between both breasts is called Sulcus intermammarius or Sinus mammarum. In a symmetry, this depression can be eliminated.

What is symmastia?

A symmastia is is when your breasts are grown together. The malformation can be congenital or the result of an unsuccessful breast augmentation with implants. In both cases, the removed depression in the midline can be aesthetically disturbing. In the case of breast augmentation with implants, the cause is a detachment of the pectoral muscle from the sternum beyond the necessary extent.

How is a symmastia correction performed?

Before each operation, the patient is meticulously checked several times to ensure maximum patient safety. The operation is not started until all requirements have been met according to the checklist.

Before the operation, the breasts are marked in a standing position. If the operation is performed in twilight sleep, you will be given medication that will relieve your anxiety and reduce your sensitivity to pain. If you do not sleep deeply anyway, you may feel something happening on the surface of your body.

The breast implant with the surrounding capsule is removed through a small incision in the area of the lower breast fold. The pectoral muscle is then reattached to the sternum. The scar tissue is firmly closed towards the midline. The pocket into which the new implants are inserted is formed above the pectoral muscle. With the Keller Funnel Method, the new breast implants are inserted gently and precisely. The procedure is also known as the "no-touch" technique. This prevents the implant from coming into contact with the surgeon's skin or hands. Depending on the findings, drainage tubes are inserted into the wound, which can be removed again after a short period of time. The wound is closed with fine threads that dissolve themselves after about three weeks.

If necessary, an additional own fat treatment can be carried out for an optimal result. The advantages of own fat treatment are: an emphasis on the cleavage, a prevention of wrinkling of the implant and an improvement in skin quality. In the operating room you will be placed in a sitting position (while still asleep) before the end of the breast augmentation operation in order to check whether the shape of the breast meets the highest standards when sitting or lying down. Finally, a bandage and a special support bra are applied.

The outpatient procedure lasts about 180 minutes. Immediately after the operation you will be continuously monitored in a so-called recovery room. You can drink something after the complete awakening and, if you tolerate it well, eat something. Before you leave the practice, appointments for check-ups will be made and the behavioural measures will be discussed with you in detail. You will receive a comprehensive written report and a telephone number where you can reach the surgeon 24 hours a day in an emergency.

Before, after and even during the operation you can watch movies or your favourite series with virtual reality glasses. This is not only entertaining, the distraction also demonstrably leads to less sensitivity to pain.

How can you prepare for the correction of symmastia?

  • All your questions about possible complications and alternative treatments should be answered before surgery.
  • Keep nicotine and alcohol consumption to a minimum.
  • The intake of hormone-containing medication (the pill) should be temporarily stopped.
  • Blood-thinning medication (e.g. ASA, Thomapyrin®) must be discontinued ten days before the operation after consultation with your doctor.
  • Stop taking vitamin preparations (A, E) and dietary supplements (e.g. omega-3 fatty acids, St. John's wort preparations) four weeks before the operation.
  • Surgery limits the ability to travel by air. Do not plan any professional or private air travel during the four weeks following the operation.
  • Take out follow-up insurance before an aesthetic operation.
  • On the day of the operation, shower with a disinfectant soap (e.g. HiBiScrub® Plus, Octenisan® Wash Lotion, Prontoderm® Shower Gel).

What do you have to consider after correcting the symmetry?

  • Your well-being and the result of the operation will be checked regularly.
  • Make sure that your upper body is raised by 30 degrees during the first five days, including when you sleep. This ensures better decongestation and wound healing.
  • During the first six weeks you should sleep on your back. This reduces the risk of the implants slipping or twisting.
  • From the third postoperative day, you can shower in the CenterPlast Saarbrücken before the wound check.
  • Wear the previously fitted support bras continuously for six weeks.
  • Massage the scar several times a day for a few minutes from the third postoperative week. Use an oily cream such as Bepanthen® Ointment or Linola® Fat. Pay attention to circular, longitudinal and transverse movements of the scar. These measures help to create an inconspicuous scar.
  • Avoid bending over, lifting heavy loads, swimming, sauna, sexual intercourse and sporting activities for four weeks. If swelling still exists, a longer period of rest may be advisable.
  • Smoking prevents the transplanted fat cells from healing and increases the risk of inflammation and thrombosis. Avoid smoking tobacco and e-cigarettes for six weeks after the operation.

Author's statement

Author: Stéphane Stahl, MD, PhD. There are no financial relationships with the pharmaceutical or medical device industries that could have influenced the above text. Any reproduction, even partial, is permitted for personal use only. All texts used on this website are protected by copyright.


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