Synmastia, often referred to as “breadloafing” or “uniboob,” is a rare but significant complication of breast augmentation where the implants move too close together, merging the cleavage line and creating an unnatural appearance. This condition can occur due to various factors, including surgical technique, implant size, and anatomical predisposition.

Causes of Synmastia
1. Surgical Technique:
○ Over-dissection of the medial pocket during surgery can create a space that allows the implants to drift towards the center of the chest.
○ Improper implant placement can also lead to synmastia, especially if the implants are placed too close together.

2. Implant Size:
○ Large implants that exert excessive pressure on the breast tissue can lead to synmastia, particularly in patients with thin or weak breast tissue.
○ The weight of the implants can cause them to migrate towards the center if not adequately supported by the surrounding tissue.

3. Anatomical Factors:
○ Patients with a naturally narrow chest or weak pectoral muscles are more prone to developing synmastia.
○ Thin skin or insufficient tissue coverage over the implants can exacerbate the condition.

4. Post-Surgical Factors:
○ Failure to follow post-operative care instructions, such as wearing a support bra, can contribute to synmastia.
○ Early resumption of strenuous physical activities can also increase the risk of implant displacement.

Symptoms of Synmastia
1. Merged Cleavage:
○ The most noticeable symptom is the merging of the cleavage, creating a continuous line between the breasts instead of a distinct separation.
○ This results in an unnatural appearance, often referred to as the “uniboob” effect.

2. Skin Tent:
○ The skin over the sternum may lift off the chest wall, creating a tent-like appearance.
○ This is caused by the excessive pressure and movement of the implants.

3. Discomfort:
○ Some patients may experience physical discomfort or pain due to the improper positioning of the implants.
○ This discomfort can be exacerbated by physical activity or certain movements.

4. Cosmetic Concerns:
○ The aesthetic impact of synmastia can be distressing for patients, leading to dissatisfaction with their breast augmentation results.
○ The unnatural appearance can affect clothing choices and overall confidence.

How the Internal Bra Can Help
The Internal Bra technique, pioneered by Dr. Don R. Revis, JR., MD, FACS, is an innovative solution for correcting synmastia. This technique involves the use of internal sutures or a supportive mesh to create a reinforced internal structure, mimicking the function of a traditional bra. Here’s how it helps:
1. Reposition and Secure Implants:
○ The Internal Bra provides a stable support system to hold the implants in their correct position, preventing them from migrating towards the center of the chest.
○ This helps maintain the desired separation between the breasts, creating a more natural cleavage.

2. Strengthen Tissue Support:
○ Reinforcing the breast tissue with sutures or mesh enhances the support around the implants, reducing the risk of future displacement.
○ This added support helps prevent the recurrence of synmastia.

3. Restore Natural Appearance:
○ By maintaining the proper distance between the implants, the Internal Bra technique helps achieve a natural and aesthetically pleasing cleavage.
○ This restoration of a natural breast contour can significantly improve patient satisfaction.

4. Prevent Recurrence:
○ The Internal Bra creates a permanent internal support structure that significantly reduces the chances of synmastia recurring.
○ This long-term solution helps ensure the stability and durability of the breast augmentation results.

Surgical Procedure for the Internal Bra
1. Consultation:
○ A thorough consultation with a board-certified plastic surgeon, such as Dr. Don R. Revis, JR., MD, FACS, is the first step. The surgeon will evaluate the patient’s condition and determine the appropriate surgical plan.

2. Surgical Technique:
○ During the procedure, the surgeon will reposition the implants and use internal sutures or a supportive mesh to create the Internal Bra.
○ The internal support structure is tailored to the patient’s anatomy to ensure optimal results.

3. Post-Operative Care:
○ Following surgery, patients must adhere to specific post-operative care instructions to ensure proper healing and prevent complications.
○ This includes wearing a support bra, avoiding strenuous activities, and attending follow-up appointments.

Conclusion
Synmastia is a challenging complication of breast augmentation, but advanced techniques like the Internal Bra offer effective solutions. This innovative approach, developed by Dr. Don R. Revis, JR., MD, FACS, provides stable support, restores natural appearance, and prevents recurrence, significantly enhancing the outcomes of breast augmentation surgery.

Frequently Asked Questions
What causes synmastia in breast implants?
Synmastia can be caused by incorrect surgical technique, implants that are too large for the patient’s chest, or naturally narrow chest anatomy and weak tissue support.

How can synmastia be prevented?
Prevention includes selecting an appropriately sized implant, using proper surgical techniques, and considering tissue reinforcement methods like the Internal Bra technique if necessary.

What are the symptoms of synmastia?
Symptoms include merged cleavage creating a “uniboob” appearance, skin lifting off the sternum (tenting), and possible physical discomfort.

How does the Internal Bra help in treating synmastia?
The Internal Bra helps by repositioning and securing implants, strengthening tissue support, restoring a natural cleavage line, and preventing recurrence through a permanent internal support structure.

About Dr. Don R. Revis, JR., MD, FACS
Dr. Don R. Revis, JR., MD, FACS, is a globally renowned plastic surgeon specializing in breast surgery. With over three decades of experience, Dr. Revis has pioneered the “Internal Bra” technique, a cutting-edge method for correcting implant malposition and preventing bottoming out. Performing over 300 primary augmentations and 350 revisions annually, Dr. Revis is dedicated to helping women achieve symmetry, poise, and confidence. His commitment to excellence and patient care has made him a leader in the field, attracting patients from around the world.

Transform Your Results with the Internal Bra
At South Florida Plastic Surgery, we are dedicated to providing exceptional care and innovative solutions. Schedule your consultation today and discover how the Internal Bra can help you achieve your ideal aesthetic results.
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