For the majority of women, there is a natural space between the right and left breast. This space creates a separation between the two breasts, so that they may both be defined as separate mounds. More importantly, it also defines the cleavage. Regardless of the size of your breast implants, it is important that this space remains for a more natural appearance.

However, if you notice that the space between your breasts has disappeared following your breast augmentation or the skin in the area is raised to a certain extent, then you have developed symmastia (a condition that can also exist congenitally). Informally referred to as "breadloafing", symmastia is a very rare risk of breast augmentation that can occur due to improper implant placement probably caused by one or more of the following:

  • a failed attempt at enhancing cleavage
  • the cutting of tissues that let the implant drift out from its intended position, most often because the pocket is too large for the implant
  • excessively large implants, particularly in thin patients who have thin skin (as the skin can be pulled away from the chest bone)
  • the weakening and stretching of tissue that separates the breasts

Breast augmentation patients with chest wall abnormalities are also at a higher risk of developing symmastia.

Symmastia, aka Uni-Boob or Breadloafing: Breasts that appear as if joined together in the middle.

Dr. Edelstein explains how to create great cleavage and avoid the Uni-Boob

The severity of symmastia varies, and it often causes the nipple/areola to appear off to the side of each breast. The condition can be safely corrected with surgery, but of course preventing it from occurring in the first place is always best.

6 Ways our Plastic Surgeons Prevent Symmastia and Botched Breast Augmentation

  1. Choosing an implant of the right size and shape for your body. The larger and wider the breast implant, the higher the risk of symmastia. While you can still get larger breast implants, it is important to understand that doing so can increase the risk. Having said this however, our Plastic Surgeons have performed breast augmentation on several patients who have chosen implants that are rather large for their body type, without any problems at all. This is because of their surgical skill and expertise.
  2. Positioning the implants properly in the body using accurate surgical techniques and instruments. Blunt dissection and creating incisions in the body “blind” can increase the risk of symmastia, as they are not precise.
  3. Creating a pocket for the implant that avoids an over-dissection of tissue in the cleavage area. The pocket should be “just right” – not too big and not too small. This involves an accurate surgical plan devised prior to performing surgery.
  4. Placing implants under the chest muscle. The chest muscles insert into the chest bone on either side of the midline. When the implant is placed under the muscle, it is almost impossible to get symmastia.
  5. Placing implants without trying to put them too close together, in a failed attempt to create cleavage.
  6. Adapting surgical techniques for patients with chests that “cave in” (chest wall deformity).

Our Plastic Surgeons refine their surgical techniques to dramatically reduce the risks associated with breast augmentation, including symmastia.

More Breast Augmentation Information

General Information

Our Unique Approach to Breast Augmentation

Dimensional Breast Augmentation


Rapid Recovery Breast Augmentation


The 24 Hour Recovery Breast Augmentation Myth

The Price of Your Breast Augmentation, Broken Down

Preparing for Your Breast Augmentation

Incision Placement

Implant Placement

Dual Plane Breast Augmentation

Asian Breast Augmentation

Augmentation Mastopexy in a Single Procedure (Single Stage)

Staged Augmentation Mastopexy

Transumbilical Breast Augmentation

Breast Implants

What Size Do I Choose?

Cohesive Gel Implants

Saline Implants

Breast Implant Projection

Breast Implant Complications Overview

Breast Implant Ruptures


Teardrop Implants Versus Round Implants

Allergan Breast Implants

Allergan Breast Implants Warranty Information

Mentor Cohesive Silicone Gel Breast Implants

Mentor Saline Breast Implants

Mentor Silicone Breast Implants Warranty

Mentor Saline Breast Implants Warranty

Breastfeeding With Breast Implants

Drop and Fluff

Mammograms and Breast Implants

Choosing The Right Breast Implants To Give You A Lift

Do Breast Implants Last For 10 Years?

Cohesive Silicone Breast Implant Ruptures

After Surgery

Your Breast Enhancement Recovery Timeline

Best Bra After Breast Augmentation

Post-Operative Care Instructions

Exercise Guidelines for Fitness Models After Breast Augmentation

Massage Exercises Following Surgery

Breast Implants and Stretch Marks

How Much Cleavage to Expect After Breast Augmentation

Breast Augmentation for Fitness Models

Natural Looking Breast Augmentation

Fake Looking Breast Augmentation

Breast Implant Removal (Explant)

Breast Augmentation and Self Esteem

Breast Augmentation and Cancer


Infection After Breast Augmentation

General Breast Information

Anatomy of the Breast

Breast Musculature

The Ideal Breast?

What is Breast Asymmetry?

Inverted Nipples

Nipple Reduction Surgery for Women

Nipple Augmentation, Nipple Reduction and Inverted Nipple Correction FAQs

Tuberous Breast Deformity

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Memberships and qualifications held by Dr. Jerome Edelstein

dr edelstein certifications

Dr. Jerome Edelstein is an active member of the American Society For Aesthetic Plastic Surgery (ASAPS), American Society of Plastic Surgeons (ASPS), Canadian Society For Aesthetic Plastic Surgery (CSAPS), Canadian Society of Plastic Surgeons (CSPS) and the International Confederation of Plastic, Reconstructive, and Aesthetic Surgery (ICPRAS). He is a Fellow of the Royal College of Physicians and Surgeons of Canada (FRCPSC) as well as is in good standing with The College of Physicians and Surgeons of Ontario.

Ongoing medical education is mandated as a condition of membership to the ASAPS, ASPS and as a Fellow of the RCPSC. This means that Dr. Edelstein always remains at the forefront of the Plastic Surgery field.

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