Creation of an intermammary sulcus in congenital synmastia

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.