Summary
Background
Symmastia is defined as medial confluence of the breast. The term ‘symmastia’ is modified
from Greek (syn meaning ‘together’, and mastos meaning ‘breast’) and was first presented
by Spence et al. in 1983. Two forms of symmastia exist: an iatrogenic and a congenital
version. Congenital symmastia is a rare condition in which web-like soft tissue traverses
the sternum to connect the breasts medially. The literature on congenital symmastia
is limited, few cases have been published, and knowledge about ideal treatment is
still insufficient.
Material and methods
Congenital symmastia was identified as a distinct deformation using a review of the
literature and a theoretical model. We analysed the malady using a three-step principle,
formulated by Blondeel, which describes the breast as a ‘footprint’, ‘conus’ and ‘skin-envelope’.
To date, few papers on congenital symmastia have been published, most of which focus
on the application of various surgical approaches. We examined the literature and
evaluated the procedures used, and are presenting two recent cases of congenital symmastia
as examples. By combining review and analysis we offer a rational treatment practice.
Results
The analysis showed that the optimal treatment begins by correcting the ‘footprint’,
removing the excess ‘conus’ over the sternum, and finally reattaching the ‘skin-envelope’
to the sternum to recreate the normal medial border of the ‘footprint’. Thus far,
the two most common approaches used to treat congenital symmastia are: reduction mammaplasty
and liposuction.
Conclusion
By combining the Blondeel analysis with a procedural review, we developed a flow chart
to offer a possible treatment practice.
Keywords
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Article info
Publication history
Published online: October 01, 2012
Accepted:
August 8,
2012
Received:
April 2,
2012
Identification
Copyright
© 2012 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.
