Breast Synmastia Surgery – In patients who have had breast implant surgery where the implants are too close to the center of the chest, there can be loss of the desired cleavage, giving the breasts an abnormal appearance. This condition is sometimes referred to as “bread loafing” but technically, it is known as synmastia. In the most extreme cases, it can almost appear as if the patient just has one breast (the so-called “uniboob”). Dr. Handel has a special interest and a great deal of experience in correcting synmastia. Typically, the condition arises because the original operating surgeon was too aggressive in dissection of the pocket for insertion of the implant. The tissues have been excessively detached from the underlying breastbone (sternum). Dr. Handel uses a variety of different techniques to correct synmastia. He has found through extensive experience that it is often most effective to insert the breast prosthesis in a “virgin” pocket. This would mean, for example, in a patient who has synmastia with implants in the subglandular (submammary) position to convert to a new pocket in the subpectoral or submuscular position. Conversely, when patients present with synmastia and have implants in the submuscular position, Dr. Handel has found it very effective to reattach the pectoral muscles to the chest wall and create a new “virgin” submammary or subglandular pocket for insertion of the breast implants. By creating a new “space” for the implant, it is possible for Dr. Handel to carefully control not only the dimensions but also the location of the periprosthetic pocket. Great care is taken to make certain that the implant is not placed too far medially. Typically, these procedures are extremely effective in reducing synmastia and have almost a 100% success rate and little, if any, chance of recurrence of the deformity. Oftentimes, it is advisable to insert new breast implants when correcting synmastia. This is because, sometimes, patients with synmastia have excessively wide or excessively large breast implants that are contributing to the problem. Dr. Handel will help you to decide what approach is best for you and what size and profile and shape implants will most effectively correct the problem and give you the result you would like.