Correction of post-surgical synmastia after stepwise treatment of pectus excavatum and breast asymmetry—A case report

TL;DR

A 30-year-old woman underwent corrective surgery to fix synmastia after treatments for funnel chest and breast asymmetry.

Contribution

A novel surgical approach using quilting sutures and synthetic mesh to correct synmastia and restore breast symmetry.

Findings

Synmastia developed due to lack of soft tissue between thoracic and breast implants.

Corrective surgery using quilting sutures and synthetic mesh successfully restored breast symmetry.

A 1-year follow-up showed preserved intermammary fold and improved aesthetics.

Abstract

We present a case of a 30-year-old female patient requiring correction of post-surgical synmastia after stepwise treatment of pectus excavatum (funnel chest) and breast asymmetry (right < left).

The funnel chest was first corrected with a 3D custom-made implant, placing the cranial part of the implant in a sub-muscular pocket. Asymmetric breast hypotrophy was corrected by means of subfascial breast augmentation one year later.

During follow-up, synmastia developed due to the lack of soft tissue interface between the distal part of the custom-made thoracic implant and the breast implants. Corrective surgery exposed the subjacent sternal periosteum excising a central wedge of the custom-made implant, allowing for quilting sutures between breast skin and periosteum to reconstruct the intermammary fold. Breast asymmetry was corrected using different implants that were hold in place by a synthetic mesh, acting as an inner bra.

At the 1-year follow-up, breast symmetry was observed with a preserved intermammary fold.

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