How do you achieve good cleavage with breast implants without synmastia or “uniboob”

Surprisingly we have seen a few patients over the years done elsewhere.  A more recent one, was old she had synmastia but this was not so.  The implants did not touch each other and in fact the cleavage was acceptable.  In the photo below, the breast implants are touching and this looks like synmastia, but fortunately for her, they neeed to be placed somewhat more laterally.  As you can see the nippple-areola complex is a little too lateral, so the implants were removed to create a more lateral location and as is turned out the midline skin was fused narually to the sternum.  No midliner fixation sutures were required.  But to help nature gain an advantage she wore a thong bra for 8 weeks and bye-bye “uniboobs.”

Harold M. Reed, M.D.
The Reed Centre for Transgender Surgery


MTF patient with “synmastia” (fusion of breasts following too medial an implantation).
Example #6 – 6/1 – 6/5

6/3 – 6/5 Status post explantation of saline implants, widening pocket laterally and inferiorly.
Intraoperatively no direct contact of implants noted. Patient opts for silicone replacement. Thong bra applied to permit lateral healing.

Incision line is inframammary and fairly well concealed


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