Symmastia is when breast implants are too close together and cross the midline of the chest. In extreme cases, the skin is pulled away from the sternal bone, allowing the right and left breast implant pockets to touch, creating a “uniboob.”
Symmastia occurs when the breast implant pocket extends beyond the desired medial contour of the breast. This can occur for a variety of reasons. One of the most common is using an implant that is too large for the patient’s anatomy. If the breast implant is too wide, the implant may extend over the sternum creating this deformity. Too large of an implant in tight-skinned patients can actually pull the skin away from the chest bone. In some cases, the patient’s anatomy is a set up for symmastia. Those with concave chest bones are especially at risk since the breast implants tend to shift toward the center. Others have very mobile skin in the midline and lack the normal attachments to the sternum. Symmastia can also occur if the surgical dissection was extended too far medially or if the surgeon divided the pectoral muscle too high. These well-intentioned attempts to “increase cleavage” lead to over-dissection and symmastia.
Correction of symmastia can be tricky. The basic principle involves revising the pocket to prevent breast implant movement across the midline. Dr. Ciaravino commonly uses a capsulorraphy technique that involves placing permanent sutures into the capsule layer along the medial breast contour. In some instances, these sutures are placed directly into the bone. The breast pocket is also modified laterally to improve implant position. Proper selection of the new breast implant based on dimensional analysis of the patient’s anatomy is important. Frequently, this involves using a slightly smaller or narrower implant. In patients with sub-glandular breast implants, converting to a sub-pectoral position (under the muscle) may correct the symmastia. Extreme cases may require more involved reconstructive techniques such as the use of acellular dermal matrix (Strattice). Post-operative taping and compression garments are commonly used.
Dr. Ciaravino has treated many patients with symmastia and has great success repairing this challenging problem.
The physician took the time to understand what I wanted out of the surgery and he is very knowledgeable and professional. The Staff is kind and supportive and the office is clean and comfortable. My overall experience was wonderful and I will highly recommend ya’ll to everyone! The doctor took the time to listen to what I wanted from the procedure and worked with me to find the perfect size. The doctor explained why the size would be perfect based on my chest cavity and it was perfectly correct!
The staff and Dr. Ciaravino are very friendly and knowledgeable. They made me feel very comfortable before and after my procedure. Everyone in the office is very friendly and professional. I did not have to wait very long and answered all of my questions. Dr. Ciaravino’s expertise and advise was greatly appreciated and very happy with the results!
Dr Michael Ciaravino is a Magnificent Surgeon!! Honest, knowledgeable, caring with excellent bedside manners. I have been his patient for several years and I will never go to another doctor. I am so happy with my recent Breast Augmentation! My recovery has been easy, and I feel great ! Thanks to Dr. Ciaravino and his Amazing Team who made my experience be a terrific one ! I can’t say enough good things about the amazing Ciaravino Girls ! Thank you beautiful ladies for being there for me.
I was extremely nervous about scheduling Breast Augmentation/Liposuction surgery without visiting the facility due to me living abroad. Upon my arrival to Texas, I was able to visit the office for a consult/pre-op. The moment I walked in I was greeted by the receptionist and amazed by the chic yet calming decor. This was very much needed since I walked in with butterflies in my stomach. The nurse/patient coordinator was very attentive and assured me of the smooth process. She was definitely right. Dr.Caravino is amazing he was able to give me a very natural yet sexy look. I’m so very thankful and planning another visit soon. Thanks again to Dr. Caravino for giving me my pre-mom body back and thank you to his staff for being just as amazing.
Very professional staff. The doctor made every visit comforting and he’s clearly great at what he does. Love the end results, 2 days after the procedure I was feeling great! No pain, no bruising, everything was awesome!
EVERYTHING! The look, the ease of transitioning back to “normal”, the care….EVERYTHING! The doctor and staff are AMAZING! He and his staff were very attentive to my questions and needs and always made me feel at ease. I have already referred three people to him!
Dr Ciaravino and his staff exceeded my expectations. I have several of my friends whose gone to him for augmentations and recommended him. I couldn’t be more pleased!! From the scheduling over the phone for the consultation to the post-op appointment, choosing this practice is by far the best decision I made for myself. I can’t express how highly I will recommend to anyone looking for a change, I actually already have passed on his information to a couple ladies. The results are more than I imagined and I only had my surgery Nov 15, 2017 (2 weeks ago). I never had to take any of my pain medicine which as my first surgery ever I didn’t expect it to be so perfect! Thank you again to you Dr Ciaravino and his lovely beautiful staff for making me feel comfortable before and after. Look forward to seeing you guys in 3 months.
Information was explained clear and concise. I felt prepared in every aspect on what to expect and how to handle myself during the recovery process. The recovery went as explained and I had minimal discomfort. I am loving my results, the whole process was wonderful!
The accessibility of the staff after my procedure to answer questions I had was phenomenal. The results are amazing, I couldn’t be happier! The staff and Dr. C are all very knowledgable and very helpful. Dr. C did a fantastic job with my procedure and I am excited to see the final results once I am completely healed.
The staff was very friendly and helpful through the entire process. My results are exactly what I wanted and asked for as far as size and shape with a more natural look.
Doctor Ciaravino gave me exactly what I wanted. I love the way my breasts look. His assistants were very knowledgeable, helpful and extremely nice! I love the way my breasts look. I wanted natural and that’s what Doctor Ciaravino gave me.
Dr C’s office and staff are first class. Always kind, helpful and considerate. Each time I go in, it feels like going to see friends! I had abdominoplasty and breast augmentation. I love my body! Could not ask for better results!
From the first consultation to my last post-op app I have been so happy with everything. Dr Ciaravino and his staff have always made me feel super comfortable. I will be going back for any cosmetic procedures I need in the future!
Friendly staff and environment. Dr. Ciaravino was very thorough about explaining the risks and possible complications of the surgery and how to prevent them. Other than what I had researched about him prior to my consultation, I knew he’d be the perfect doctor to perform my surgery because of his bedside manner skills! Down to earth and doesn’t make you feel like a number. He addresses your concerns and took the time to explain my questions.
Everyone from the CSM to the nurse who has been on staff for 8 years. Everyone made my husband and I feel very welcomed and comfortable. Didn’t feel pressured and the staff was very informative!
Nadia helped explain every single thing I would need to know in such detail, I felt that I knew exactly what I was getting into. She is so sweet and kind I was nervous and she helped calm my nerves and make me feel right at home. By the time the surgeon entered the room, I had most of my questions answered so I felt fully ready and excited. Nadia is the BEST.
Dr. C, you and your staff are great!! You all made the whole process practically painless. I am very impressed with the results…You are so professional and at the same time so compassionate and caring, another happy patient!!
I cannot say enough wonderful things about every single person I encountered at this office. You are all thorough, kind, conscientious, and beautiful inside and out!
I have always been a bit apprehensive about having breast augmentation. Although I wanted one, I had a fear that they would turn out too big and look unnatural. Dr. Ciaravino listened to my concerns and truly did a beautiful job. He is truly an artist with his ability and truly did a beautiful job.
Just wanted to let y’all know that I think that Dr. Ciaravino is by far the most talented doc around. I had my surgery on Monday and haven’t had a pain killer since Tuesday morning. Not even a Tylenol. There was no bruising or swelling at all. I am just amazed at how simple and painless the whole thing was. I attribute this to Dr. Ciaravino’s talent and gentleness.