Symmastia is one of the rarer, but more expensive and difficult complications to repair. It has many different names including synmastia, breadloafing, kissing breast implants, and uniboob.
Basically, when symmastia occurs, the implants meet in the middle of the chest. There is no separation between the implants, hence the name “kissing implants.” The skin literally lifts off of the sternum/breast bone. In cases where implants are beneath the muscle, not only does the skin lift, the pectoral muscle also lifts away from the sternum. It causes pain and discomfort, along with the obvious distortion of the breasts, which can only be disguised with clothing that does not show cleavage.
If the implants are placed above the muscle, a symmastia repair usually involves moving the breast implants into the submuscular position. This creates a whole new pocket for the breast implant.
In cases of symmastia where breast implants are placed beneath the muscle, there are a couple of options. The first is to move the breast implants into the subglandular position. The second is to keep the breast implants in the submuscular position while at the same time repairing the cleavage area. In the latter, case, a portion of the breast implant capsule is used as an anchor so that the muscles and tissues can be sutured to the sternum. In other cases, the capsule is not used, and instead, soft tissue grafts such as Flex HD, Strattice, etc., are used as anchors. Tissue grafts are very strong, come in various thicknesses, and work very well, although they can be quite expensive. However, if the tissue graft offers a better success rate for symmastia repair, it is certainly worth the cost. Failure of a symmastia repair means more surgery and more expensive.