Creation of an intermammary sulcus in congenital synmastia

Wong MTC, Cheong EC, Lim J, Lim TC
Correspondence: Dr Marcus Wong, surv21@nus.edu.sg

ABSTRACT
Synmastia is a condition where both breasts appear conjoint without an intervening intermammary sulcus. This is usually the result of technical complications during breast implant surgery caused by over-dissection of the medial pocket over the sternum in the subglandular plane, or by an over-division of the pectoralis muscle origin along the sternum in a submuscular plane. As a congenital problem, this is very rare with only a single previous report of an attempt to correct this anomaly. We report a rare case of synmastia in a 19-year-old Indian woman. She had no previous surgery or family history of the condition. Vertical-scar reduction mammoplasty was performed for the hypertrophic breasts. Using the same access, the synmastia was corrected. This approach avoided incisions on the sternum, which is one of the keloid-prone sites on the body. Eight months postoperation, the intermammary sulcus was maintained.

Keywords: breast reconstruction, congenital synmastia, intermammary sulcus, mammoplasty, synmastia
Singapore Med J 2007; 48(1): e29–e31